The early predictive value of serum Cys-c,NLRP3 inflammasome and IL-18 levels in septic AKI patients
Objective To investigate the early predictive value of Cys-c and NLRP3 inflammasome and IL-18 levels in pa-tients with septic AKI.Methods 42 cases of sepsis and 61 cases of sepsis AKI were selected as the study objects.The patients were di-vided into sepsis group and sepsis AKI group according to Sepsis3.0 and the diagnostic criteria of AKI.Basic data such as age,SOFA score,acute physiology and chronic health status score Ⅱ(APACHEⅡ score),ICU stay time,mechanical ventilation time,total hospitali-zation days were collected in order to detect and compare the levels of serum Cys-c,NLRP3 and IL-18 of patients in two groups.logis-tic regression was used to investigate the influencing factors of AKI in patients with sepsis.The predictive ability of serum Cys-c,NLRP3 and IL-18 for AKI in patients with sepsis was determined by receiver operating characteristic(ROC)curve.According to 28-day sur-vival,patients with sepsis AKI were divided into survival group and death group,and the levels of Cys-c,NLRP3 and IL-18 were com-pared between the two groups.Results Univariate analysis suggested that the levels of serum Cys-c,NLRP3 and IL-18 in patients with sepsis AKI group were significantly higher than those in patients with sepsis group(P＜0.05).Multivariate logistic regression anal-ysis showed that the levels of serum Cys-c and NLRP3 were independent risk factors for AKI in sepsis Patients.In ROC curve analysis,the AUC values of serum Cys-c,NLRP3 and IL-18 were 0.805(95％CI:0.722～0.889),0.850(95％CI:0.776～0.924),and 0.772(95％CI:0.678～0.866),respectively.Serum Cys-c combined with IL-18 predicted the AUC value of 0.861 in patients with sepsis,and serum Cys-c combined with NLRP3 predicted the AUC value of 0.810 in patients with sepsis.The combination of serum Cys-c and IL-18 was superior to a single index.According to 28-day survival,patients with septic AKI were divided into survival group and death group.Compared with survival group,IL-18 level in death group was significantly increased(P＜0.05).Conclusion Serum levels of Cys-c,NLRP3 and IL-18 have certain predictive value in early stage of AKI patients with sepsis.
万方数据
维普
