血清高迁移率族蛋白1及白细胞介素-18对老年脓毒症并发急性肾损伤患者的预后评估价值

doi:10.3969/j.issn.1002-1949.2019.10.007

Chinese Journal of Critical Care Medicine

2019, Vol. 39

Issue (10): 953-957 DOI: 10.3969/j.issn.1002-1949.2019.10.007

Prognostic value of serum HMGB1 and IL-18 in elderly patients with sepsis complicated with acute kidney injury

Qiu Yu-xia, Sun Yue-ling, Gong Bao-qiang, Lin Sen, Guan Wan-tao

Intensive Care Unit，Third People′s Hospital of Hainan Province， Sanya 572000，Hainan Province，China

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Abstract Objective To investigate the prognostic value of serum high mobility group protein 1 (HMGB1) and interleukin-18 (IL-18) in elderly patients with sepsis complicated with acute kidney injury (AKI). Methods A total of 248 elderly sepsis patients with AKI admitted to the Third People′s Hospital of Hainan Province from January 2016 to December 2018 were selected and divided into survival group (n=157) and death group (n=91) according to their mortality. According to AKI staging criteria, they were divided into AKI 1 (n=105), AKI 2 (n=86) and AKI 3 (n=57). Serum levels of HMGB1 and IL-18 were measured by ELISA. The prognostic value of serum HMGB1 and IL-18 levels in elderly patients with sepsis complicated with AKI was analyzed by ROC curve. Results The serum levels of HMGB1 (μg/L:176.40±27.80 vs. 108.52±21.46) and IL-18 (ng/L:96.70±12.46 vs. 70.84±8.25) in the death group were significantly higher than those in the survival group (P<0.05). Serum levels of HMGB1 (μg/L:194.35±30.26 vs. 102.35±21.70，121.60±23.48) and IL-18 (ng/L:105.74±15.26 vs. 68.30±8.42，75.20±8.27) in AKI stage 3 were significantly higher than those in AKI stage 1 and AKI stage 2 (P<0.05). ROC curve analysis showed that the best cut-off values of serum HMGB1 and IL-18 levels for evaluating the mortality of elderly sepsis complicated with AKI were 142.50 ug/L and 85.62 ng/L, respectively. The AUC（0.904，95%CI0.842～0.961） of elderly sepsis complicated with AKI was the highest in the two combined assessments, with the sensitivity and specificity of 92.5% and 84.6%. Pearson correlation analysis showed that serum HMGB1 was positively correlated with IL-18 in the death group (r=0.743, P<0.01). Conclusion Serum HMGB1 and IL-18 levels are significantly increased in patients with death, and the two combined tests are of high value in the evaluation of death in elderly sepsis complicated with AKI.

Key words： Sepsis Acute kidney injury Elderly High mobility group protein 1 Interleukin-18

About author:: Qiu Yu-xia, E-mail:13518092412@163.com

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Qiu Yu-xia,Sun Yue-ling,Gong Bao-qiang, et al. Prognostic value of serum HMGB1 and IL-18 in elderly patients with sepsis complicated with acute kidney injury[J]. Chinese Journal of Critical Care Medicine, 2019, 39(10): 953-957.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2019.10.007 OR http://www.cnemergency.org.cn/EN/Y2019/V39/I10/953

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