LRG1、sCD14-st、CD163预测脓毒症急性肾损伤预后的价值研究

The prognostic value of LRG1, sCD14-st, and CD163 in sepsis-associated acute kidney injury

摘要:

目的 探讨富亮氨酸α-2糖蛋白1（LRG1）、可溶性白细胞分化抗原14亚型（sCD14-st）和集落分化抗原163（CD163）对脓毒症合并急性肾损伤（AKI）患者预后的预测价值。方法 选取2022年1月—2024年12月宁夏回族自治区人民医院收治的102例脓毒症合并AKI患者，依据治疗后28 d的预后情况将其分为预后良好组70例和预后不良组32例。检测患者LRG1、sCD14-st和CD163水平，并分析各生物标志物单独及联合检测在预测脓毒症合并AKI患者预后不良方面的效能。结果 预后不良组机械通气时间、血清LRG1、sCD14-st和CD163水平均高于预后良好组（P <0.05）。多因素一般Logistic回归分析结果显示：机械通气时间长［O^R=1.050（95% CI：1.019，1.081）］、LRG1水平高［O^R=1.015（95% CI：1.002，1.029）］、sCD14-st水平高［O^R=18.203（95% CI：3.737，88.666）］和CD163水平高［O^R=1.014（95% CI：1.006，1.021）］均是脓毒症合并AKI患者预后不良的危险因素（P <0.05）。受试者工作特征曲线分析结果显示，血清LRG1、sCD14-st和CD163联合检测预测脓毒症合并AKI患者预后不良的敏感性为71.9%（95% CI：0.532，0.862），特异性为97.1%（95% CI：0.900，0.996），3者联合预测效能最高。结论 LRG1、sCD14-st和CD163联合检测在脓毒症合并AKI患者预后评估中具有较高的诊断效能，能够为临床提供有效的预后预测依据。

Abstract:

Objective To explore the prognostic value of leucine-rich alpha-2-glycoprotein 1 (LRG1), soluble CD14 subtype (sCD14-st), and CD163 in patients with sepsis-associated acute kidney injury (AKI).Methods A total of 102 patients with sepsis complicated by acute kidney injury (AKI) who were admitted to the People's Hospital of Ningxia Hui Autonomous Region from January 2022 to December 2024 were enrolled. According to their prognosis at 28 days after treatment, they were divided into a good prognosis group (n = 70) and a poor prognosis group (n = 32). The levels of LRG1, sCD14-st, and CD163 were detected in all patients, and the diagnostic performance of each biomarker, as well as their combined detection, in predicting the poor prognosis of sepsis-associated AKI was analyzed.Results The duration of mechanical ventilation was longer and serum levels of LRG1, sCD14-st, and CD163 were higher in the poor prognosis group than those in the good prognosis group (P < 0.05). Multivariable Logistic regression analysis showed that longer duration of mechanical ventilation [O^R = 1.050 (95% CI: 1.019, 1.081) ], higher LRG1 levels [O^R = 1.015 (95% CI: 1.002, 1.029) ], higher sCD14-st levels [O^R = 18.203 (95% CI: 3.737, 88.666) ], and higher CD163 levels [O^R = 1.014 (95% CI: 1.006, 1.021) ] were all independent risk factors for poor prognosis in sepsis patients with AKI (P < 0.05). ROC curve analysis indicated that the combined detection of serum LRG1, sCD14-st, and CD163 had the highest predictive performance for poor prognosis in sepsis patients with AKI, with a sensitivity of 71.9% (95% CI: 0.532, 0.862) and a specificity of 97.1% (95% CI: 0.900, 0.996).Conclusion The combined detection of LRG1, sCD14-ST, and CD163 demonstrates high diagnostic performance in prognostic evaluation of patients with sepsis-associated AKI and may provide valuable predictive information for clinical decision-making.