Predictive Value of Serum TXNIP and NRP1 Levels for Acute Renal Injury in Sepsis Patients
Objective:To analyze the predictive value of thioredoxin interacting protein(TXNIP)and neuronilin-1(NRP1)for acute renal injury(AKI)in sepsis patients.Methods:160 patients with sepsis admitted to our hospital from April 2019 to April 2021 were selected as the study object.According to the occurrence of AKI within 7 days,the patients were divided into AKI group(56 cases)and non-AKI group(104 cases),and then AKI patients were divided into stage Ⅰ,stage Ⅱand stage Ⅲ.Ser-um TXNIP and NRP1 levels by ELISA;multivariate logistic regression analysis was used to analyze the possible influencing factors of AKI in sepsis patients;the predictive value of serum TXNIP and NRP1 levels in the development of AKI in sepsis patients was evalua-ted by ROC curve.Results:The SOFA score,Scr level,APACHE Ⅱ score and PCT level in AKI group were obviously higher than those in non AKI group,the eGFR level was obviously lower than that in non AKI group(P＜0.05).The TXNIP level in AKI group was obviously higher than that in non AKI group,and increased obviously with the increase of AKI stage(P＜0.05);NRP1 level was obviously lower than that of non AKI group,and decreased obviously with the increase of AKI stage(P＜0.05).Serum TXNIP level in AKI patients was positively correlated with SOFA score,Scr and APACHEⅡ score(r=0.342,0.361,0.335,P＜0.05),and negatively correlated with Egfr(r=-0.495,P＜0.05).Serum NRP1 level was negatively correlated with SOFA score,Scr,A-PACHEⅡscore(r=-0.310,-0.327,-0.306,P＜0.05),and positively correlated with Egfr(r=0.561,P＜0.05).Logis-tic regression analysis showed that high TXNIP,Scr and SOFA score were risk factors for AKI in sepsis patients(P＜0.05),the high NRP1 level was the protective factor of AKI in sepsis patients(P＜0.05).The ROC curve showed that the AUC of TXNIP and NRP1 for predicting AKI was 0.737 and 0.720,and the AUC of the combination of TXNIP and NRP1 for predicting AKI was 0.929,which was obviously higher than that of the combination of TXNIP and NRP1 alone(Z combination VS.TXNIP=4.642,P=0.004;Z combination VS.NRP1=4.929,P=0.025),the sensitivity and specificity were 90.79% and 85.29%,respectively.Conclusion:TXNIP is highly expressed and NRP1 is low expressed in the serum of patients with sepsis complicated with AKI,they are related to the severity of AKI.The combination of the two has a certain predictive value for sepsis with AKI.
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