Ruge Toralph, Larsson Anders, Lipcsey Miklós, Tydén Jonas, Johansson Joakim, Eriksson Mats
Department of Emergency and Internal Medicine, Skåne University Hospital, 214 28 Malmö, Sweden.
Department of Clinical Sciences Malmö, Lund University, 214 28 Malmö, Sweden.
Biomedicines. 2021 Nov 3;9(11):1603. doi: 10.3390/biomedicines9111603.
Endostatin may predict mortality and kidney impairment in general populations as well as in critically ill patients. We decided to explore the possible role of endostatin as a predictor of 30-day mortality, acute kidney injury (AKI), and renal replacement therapy (RRT) in a cohort of unselected intensive care unit (ICU) patients. Endostatin and creatinine in plasma were analyzed and SAPS3 was determined in 278 patients on ICU arrival at admission to a Swedish medium-sized hospital. SAPS3 had the highest predictive value, 0.85 (95% C.I.: 0.8-0.90), for 30-day mortality. Endostatin, in combination with age, predicted 30-day mortality by 0.76 (95% C.I.: 0.70-0.82). Endostatin, together with age and creatinine, predicted AKI with 0.87 (95% C.I.: 0.83-0.91). Endostatin predicted AKI with [0.68 (0.62-0.74)]. Endostatin predicted RRT, either alone [0.82 (95% C.I.: 0.72-0.91)] or together with age [0.81 (95% C.I.: 0.71-0.91)]. The predicted risk for 30-day mortality, AKI, or RRT during the ICU stay, predicted by plasma endostatin, was not influenced by age. Compared to the complex severity score SAPS3, circulating endostatin, combined with age, offers an easily managed option to predict 30-day mortality. Additionally, circulating endostatin combined with creatinine was closely associated with AKI development.
内皮抑素可能在普通人群以及危重症患者中预测死亡率和肾脏损害。我们决定在一组未经挑选的重症监护病房（ICU）患者中探究内皮抑素作为30天死亡率、急性肾损伤（AKI）及肾脏替代治疗（RRT）预测指标的潜在作用。在一家瑞典中型医院，对278例入住ICU的患者入院时血浆中的内皮抑素和肌酐进行了分析，并测定了其简化急性生理学评分第3版（SAPS3）。SAPS3对30天死亡率的预测价值最高，为0.85（95%置信区间：0.8 - 0.90）。内皮抑素与年龄相结合，对30天死亡率的预测值为0.76（95%置信区间：0.70 - 0.82）。内皮抑素与年龄和肌酐一起，对AKI的预测值为0.87（95%置信区间：0.83 - 0.91）。内皮抑素对AKI的预测值为[0.68（0.62 - 0.74）]。内皮抑素单独[0.82（95%置信区间：0.72 - 0.91）]或与年龄一起[0.81（95%置信区间：0.71 - 0.91）]均可预测RRT。血浆内皮抑素预测的ICU住院期间30天死亡率、AKI或RRT的预测风险不受年龄影响。与复杂的严重程度评分SAPS3相比，循环内皮抑素与年龄相结合，为预测30天死亡率提供了一种易于操作的方法。此外，循环内皮抑素与肌酐相结合与AKI的发生密切相关。
