Nguyen Van Tri, Nguyen-Phan Hong Ngoc, Ton That Ngoc, Hoang Bui Bao
Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam.
Department of Anesthesiology of Hue International Medical Center, Hue Central Hospital, Hue City, Vietnam.
Int J Gen Med. 2023 Jul 10;16:2933-2941. doi: 10.2147/IJGM.S417410. eCollection 2023.
To investigate the serum soluble thrombomodulin (sTM) concentration in patients with sepsis-associated acute kidney injury (AKI) and to determine the value of sTM in predicting AKI and mortality in sepsis patients.
This prospective observational study was conducted on 71 patients diagnosed with sepsis according to Sepsis 3 at the Intensive Care Unit, Hue Central Hospital, Vietnam, from September 2021 to February 2023.
Among 71 sepsis patients, there were 38 (53.5%) AKI cases, including 16 (22.5%) cases of stage 1 AKI, 14 (19.7%) cases of stage 2 AKI, 8 (11.3%) cases of stage 3 AKI, 16 (22.5%) cases of renal replacement therapy, 28 (39.4%) cases of septic shock, and 21 (29.6%) cases of mortality within 28 days. The concentrations of lactate and IL-6 in the AKI and mortality groups were statistically significantly greater than those in the non-AKI and survival groups (p < 0.05). The serum sTM concentration was 4.33 ng/mL, the serum sTM level in the AKI group was statistically significantly higher than that in the non-AKI group (sTM [4.71 vs 2.54 ng/mL, p < 0.001]), and the serum sTM level in the mortality group was statistically significantly higher than the survival group (sTM [4.78 vs 3.87 ng/mL, p < 0.001]). The AUC of sTM for predicting AKI was 0.864; the AUCs of sTM, IL-6, SOFA, and APACHE II for predicting mortality were 0.811, 0.671, 0.816, and 0.705, respectively.
AKI was a prevalent complication among sepsis patients at the ICU. In the AKI and mortality groups, sTM concentration was statistically significantly higher than that in the non-AKI and survival groups. sTM was the predictor of acute kidney injury and mortality in patients with sepsis.
探讨脓毒症相关急性肾损伤（AKI）患者血清可溶性血栓调节蛋白（sTM）浓度，并确定sTM在预测脓毒症患者AKI及死亡率方面的价值。
本前瞻性观察性研究于2021年9月至2023年2月在越南顺化中央医院重症监护病房对71例根据脓毒症3定义诊断为脓毒症的患者进行。
71例脓毒症患者中，有38例（53.5%）发生AKI，其中16例（22.5%）为1期AKI，14例（19.7%）为2期AKI，8例（11.3%）为3期AKI，16例（22.5%）接受肾脏替代治疗，28例（39.4%）发生脓毒症休克，21例（29.6%）在28天内死亡。AKI组和死亡组的乳酸和IL-6浓度在统计学上显著高于非AKI组和存活组（p<0.05）。血清sTM浓度为4.33 ng/mL，AKI组血清sTM水平在统计学上显著高于非AKI组（sTM[4.71对2.54 ng/mL，p<0.001]），死亡组血清sTM水平在统计学上显著高于存活组（sTM[4.78对3.87 ng/mL，p<0.001]）。sTM预测AKI的AUC为0.864；sTM、IL-6、序贯器官衰竭评估（SOFA）和急性生理与慢性健康状况评分系统II（APACHE II）预测死亡率的AUC分别为0.811、0.671、0.816和0.705。
AKI是重症监护病房脓毒症患者中常见的并发症。在AKI组和死亡组中，sTM浓度在统计学上显著高于非AKI组和存活组。sTM是脓毒症患者急性肾损伤和死亡率预测指标。
