The early diagnostic value of OLFM-4,SCUBE-1 combined with L-FABP in patients with severe pneumonia complicated with acute kidney injury
Objective To investigate the early diagnostic value of human olfactomedin 4(OLFM-4),signal peptide-CUB-epidermal growth factor-like domain-containing protein 1(SCUBE-1),and liver-type fatty acid binding protein(L-FABP)in severe pneumonia complicated with acute kidney injury(AKI).Methods A total of 162 patients with severe pneumonia admitted to the Haikou Third People's Hospital from January 2020 to May 2023 were prospectively selected and divided into an AKI group(54 cases)and a non AKI group(108 cases)based on whether they developed AKI.Among AKI patients,there were 23 cases of AKI stage 1,18 cases of AKI stage 2,and 13 cases of AKI stage 3.Enzyme linked immunosorbent assay was used to measure the changes in urinary OLFM-4,SCUBE-1,and L-FABP levels of patients at 12,24,and 48 h after admission to the intensive care unit(ICU).The receiver operating characteristic(ROC)curve was applied to analyze the early diagnostic value of urinary OLFM4,SCUBE-1,and LFABP levels at different time points for AKI in patients with severe pneumonia.Results There were statistically significant differences in ICU admission time,serum creatinine,urea nitrogen,uric acid,serum albumin,C-reactive protein,procalcitonin,Sequential Organ Failure Assessment(SOFA)score,and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score between the AKI group and the non AKI group(all P＜0.05).At 12,24,and 48 h after admission to the ICU,the urinary OLFM-4,SCUBE-1,and L-FABP levels in the AKI group were significantly higher than those in the non AKI group,and the differences were statistically significant(all P＜0.001).The levels of urinary OLFM-4,SCUBE-1,and L-FABP in AKI stage 3 patients were significantly higher than those in AKI stage 1 and AKI stage 2 at all time points after admission to the ICU(all P＜0.001),and the highest levels of urinary OLFM-4,SCUBE-1,and L-FABP were observed at the 24 h time point.The combination of 24 h urine OLFM-4 and SCUBE-1 with L-FABP had the highest area under the curve(AUC)for diagnosing severe pneumonia complicated with AKI(AUC=0.964,95％CI:0.908-0.997),with a sensitivity of 98.2％and specificity of 88.3％.Pearson correlation analysis showed that urinary OLFM-4 and SCUBE-1 levels in AKI patients were positively correlated with L-FABP(r=0.870,0.775,all P＜0.001).Conclusions Urine OLFM-4,SCUBE-1,and L-FABP are significantly elevated in the early stage of severe pneumonia complicated with AKI.The combined detection of these three parameters at 24 h has high value for the early diagnosis of AKI.
PneumoniaAcute kidney injuryOLFM4 proteinSCUBE-1 proteinLive-type fatty acid-binding protein
万方数据
维普
