首页|维持性血液透析患者血清SAA、YKL-40、HBP与透析导管相关性感染及预后的相关性分析

维持性血液透析患者血清SAA、YKL-40、HBP与透析导管相关性感染及预后的相关性分析

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  • NETL
  • NSTL
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目的 探讨维持性血液透析(MHD)患者血清淀粉样蛋白A(SAA)、几丁质酶3样蛋白1(YKL-40)、肝素结合蛋白(HBP)与透析导管相关性感染及预后的相关性.方法 选取2020年1月至2022年10月河南南阳市第二人民医院收治的124例维持性血液透析患者为研究对象.根据患者是否发生透析导管相关感染分为感染组(28例)及非感染组(96例),比较两组血清SAA、YKL-40、HBP水平;根据治疗30d后随访情况分为预后良好组(104例)及预后不良组(20例),分析影响MHD患者预后的独立影响因素,分析血清SAA、YKL-40、HBP单一及联合检测对MHD患者预后情况的预测价值.结果 感染组患者血清SAA、YKL-40、HBP水平均高于非感染组,差异有统计学意义(t=56.461、7.902、42.037,P<0.05);预后良好组患者C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)、血肌酐(Scr)、血尿素氮(BUN)、SAA、YKL-40、HBP水平低于预后不良组,差异有统计学意义(t=3.668、23.009、17.639、6.656、13.821、45.366、7.849、43.443,P<0.05);Logistic分析显示,CRP、TNF-α、PCT、Scr、BUN、SAA、YKL-40、HBP是MHD患者预后不良的危险因素(P<0.05);血清SAA、YKL-40、HBP单一及联合预测MHD患者预后AUC分别0.894、0.749、0.818、0.964,联合预测优于单一预测(P<0.05).结论 MHD合并透析导管相关性感染患者血清SAA、YKL-40、HBP水平较无合并感染患者升高,血清SAA、YKL-40、HBP联合检测对MHD患者预后情况具有良好的预测价值.
Correlation analysis of serum SAA,YKL-40,HBP and dialysis catheter-associated infection and prognosis in maintenance hemodialysis patients
Objective To investigate the correlation between serum amyloid A(SAA),chitinase 3-like protein 1(YKL-40),heparin-binding protein(HBP)and dialysis catheter-associated infection and prog-nosis in maintenance hemodialysis(MHD)patients.Methods A total of 124 maintenance hemodialysis pa-tients admitted to the Second People's Hospital of Nanyang City,Henan Province from January 2020 to Octo-ber 2022 were selected as the study subjects.Patients were divided into two groups:an infected group(28 cas-es)and a non-infected group(96 cases)based on whether they had dialysis catheter-related infections.Serum levels of SAA,YKL-40 and HBP were compared between the two groups.The patients were further divided in-to a good prognosis group(98 cases)and a poor prognosis group(20 cases)based on their follow-up after 30 days of treatment.Independent factors affecting the prognosis of MHD patients were analyzed using univariate and multivariate analysis.The predictive value of single and combined detection of serum SAA,YKL-40 and HBP on the prognosis of MHD patients was also analyzed.Results Serum levels of SAA,YKL-40 and HBP in the infected group were higher than those in the non-infected group,with statistical significance(t=56.461,7.902,42.037,P<0.05).The levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),procalci-tonin(PCT),serum creatinine(Scr),blood urea nitrogen(BUN),SAA,YKL-40 and HBP in the good prog-nosis group were lower than those in the poor prognosis group,with statistical significance(t=3.668,23.009,17.639,6.656,13.821,45.366,7.849,43.443,P<0.05).Logistic analysis showed that CRP,TNF-α,PCT,Scr,BUN,SAA,YKL-40 and HBP were risk factors for poor prognosis in MHD patients(P<0.05).The AUC of serum SAA,YKL-40 and HBP was 0.894,0.749,0.818 and 0.964,respectively,and the combined predic-tion was better than the single prediction(P<0.05).Conclusion The serum levels of SAA,YKL-40 and HBP in MHD patients with dialysis catheter-associated infection are higher than those in patients without co-infec-tion.The combined detection of SAA,YKL-40 and HBP has good prognostic value in MHD patients.

Maintenance hemodialysisDialysis catheter-associated infectionSerum amyloid AChitinase 3-like protein 1Heparin-binding protein

陈庆云、马亚琼、苏裕

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南阳市第二人民医院肾病科,河南,南阳 473000

维持性血液透析 透析导管相关性感染 血清淀粉样蛋白A 几丁质酶3样蛋白1 肝素结合蛋白

河南省科技厅项目

20220042X

2024

分子诊断与治疗杂志
中山大学

分子诊断与治疗杂志

CSTPCD
影响因子：0.65
ISSN：1674-6929
年,卷(期)：2024.16(5)
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