预测重症监护病房患者的急性肾损伤：组织金属蛋白酶抑制剂-2 和胰岛素样生长因子结合蛋白-7 生物标志物的作用。
Predicting Acute Kidney Injury in Intensive Care Unit Patients: The Role of Tissue Inhibitor of Metalloproteinases-2 and Insulin-Like Growth Factor-Binding Protein-7 Biomarkers.
机构信息
International Renal Research Institute of Vicenza, San Bortolo Hospital, Vicenza, Italy.
Department of Nephrology, Dialysis and Transplantation, San Bortolo Hospital, Vicenza, Italy.
出版信息
Blood Purif. 2018;45(1-3):270-277. doi: 10.1159/000485591. Epub 2018 Jan 26.
BACKGROUND
Acute kidney injury (AKI) diagnosis is based on a rise in serum creatinine and/or fall in urine output. It has been shown that there are patients that fulfill AKI definition but do not have AKI, and there are also patients with evidence of renal injury who do not meet any criteria for AKI. Recently the innovative and emerging proteomic technology has enabled the identification of novel biomarkers that allow improved risk stratification.
METHODS
Tissue inhibitor of metalloproteinases-2 (TIMP-2), insulin-like growth factor-binding protein 7 (IGFBP7) were measured to a cohort of 719 consecutive patients admitted to Intensive Care Unit (ICU). The primary endpoint was the evaluation of clinical performances of the biomarkers focusing on the probability do develop AKI in the first 7 days.
RESULTS
The Kaplan-Meier analysis considering the first 7 days of ICU stay suggested a lower risk of developing AKI (p < 0.0001) for patients with a negative (<0.3; TIMP-2*IGFBP7) test.
CONCLUSION
(TIMP-2*IGFBP7) at ICU admission has a good performance in predicting AKI, especially in the first 4 days in ICU.
背景
急性肾损伤（AKI）的诊断基于血清肌酐升高和/或尿量减少。已经表明，有些患者符合 AKI 定义但没有 AKI，还有些患者有肾脏损伤的证据但不符合 AKI 的任何标准。最近，创新的新兴蛋白质组学技术已经能够识别出新型生物标志物，从而实现更好的风险分层。
方法
对入住重症监护病房（ICU）的 719 例连续患者进行了金属蛋白酶组织抑制剂 2（TIMP-2）和胰岛素样生长因子结合蛋白 7（IGFBP7）的测量。主要终点是评估生物标志物的临床性能，重点是在第 7 天内发生 AKI 的概率。
结果
考虑 ICU 入住的前 7 天的 Kaplan-Meier 分析表明，对于测试结果为阴性（<0.3；TIMP-2*IGFBP7）的患者，发生 AKI 的风险较低（p < 0.0001）。
结论
（TIMP-2*IGFBP7）在 ICU 入院时具有良好的预测 AKI 的性能，尤其是在 ICU 入住的前 4 天。
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