脓毒症患者TLR9、GDF15表达水平及与急性肾损伤发生的关系OA
Expression Levels of Serum TLR9 and GDF15 in Patients with Sepsis and Their Relationship with the Occurrence of Acute Kidney Injury
目的 探讨Toll样受体9(TLR9)、生长分化因子15(GDF15)水平与脓毒症患者急性肾损伤(AKI)发生的关系.方法 回顾性选取2020年1月至2024年6月西安交通大学第一附属医院收治的106例脓毒症患者作为对照组,另选择同期160例脓毒症相关AKI患者作为研究组.比较两组患者临床资料及TLR9、GDF15表达水平;采用Spearman相关分析探讨脓毒症患者TLR9、GDF15表达水平与AKI发生的相关性,采用受试者工作特征(ROC)曲线评估TLR9、GDF15表达水平对AKI发生的预测价值.结果 研究组患者呼吸频率、心率、血糖、肌酐、乳酸水平、感染来源(腹腔感染)比例高于对照组,血氧饱和度、白蛋白、血红蛋白、血小板计数、平均动脉压水平低于对照组(P<0.05);研究组TLR9、GDF15表达水平高于对照组(P<0.05);Spearman相关分析结果显示,TLR9、GDF15表达水平与AKI发生呈正相关(r=0.587、0.621,均P<0.05);乳酸(OR=2.309,95%CI:1.184～4.506)、平均动脉压(OR=2.155,95%CI:1.066～4.356)、肌酐(OR=2.077,95%CI:1.014～4.256)、TLR9(OR=2.606,95%CI:1.471～4.620)和GDF15(OR=2.492,95%CI:1.437～4.322)是脓毒症患者AKI发生的独立危险因素(P<0.05);TLR9、GDF15表达水平及联合预测脓毒症相关AKI发生的曲线下面积分别为0.812、0.759、0.813.结论 TLR9、GDF15表达水平与脓毒症相关AKI发生的关系密切,有望作为脓毒症相关AKI发生的预测指标.
Objective To investigate the relationship between the levels of Toll-like receptor 9(TLR9)and growth differentiation factor 15(GDF15)and the occurrence of acute kidney injury(AKI)in patients with sepsis.Methods A total of 106 patients with sepsis admitted to the First Affiliated Hospital of Xi'an Jiaotong University from January 2020 to June 2024 were retrospectively selected as the control group,and 160 patients with sepsis-associated AKI during the same period were selected as the study group.The clinical data and expression levels of TLR9 and GDF15 were compared between the two groups.Spearman correlation analysis was used to explore the correlation between TLR9 and GDF15 expression levels and the occurrence of AKI in sepsis patients.Receiver operating characteristic(ROC)curve analysis was applied to evaluate the predictive value of TLR9 and GDF15 expression levels for AKI.Results The levels of respiratory rate,heart rate,glucose,creatinine,lactate,along with the proportion of infection originating from an intra-abdominal source,in the study group were higher than those in the control group,while the levels of oxygen saturation,albumin,hemoglobin,platelet count,and mean arterial pressure(MAP)were lower(P<0.05).The expression levels of TLR9 and GDF15 in the study group were higher than those in the control group(P<0.05).Spearman correlation analysis showed that the expression levels of TLR9 and GDF15 were positively correlated with the occurrence of AKI(r=0.587,0.621,both P<0.05).lactate(OR=2.309,95%CI:1.184-4.506),MAP(OR=2.155,95%CI:1.066-4.356),creatinine(OR=2.077,95%CI:1.014-4.256),TLR9(OR=2.606,95%CI:1.471-4.620),and GDF15(OR=2.492,95%CI:1.437-4.322)were identified as independent risk factors for AKI in sepsis patients(P<0.05).The area under the curve of TLR9,GDF15,and their combination for predicting sepsis-associated AKI were 0.812,0.759,and 0.813,respectively.Conclusion The expression levels of TLR9 and GDF15 are closely associated with the occurrence of sepsis-associated AKI and may serve as predictive indicators for sepsis-associated AKI.
邢斌瑜;申存毅;林婷;谭文君
西安交通大学第一附属医院外科重症医学科,西安 710061西安交通大学第一附属医院外科重症医学科,西安 710061西安交通大学第一附属医院外科重症医学科,西安 710061西安交通大学第一附属医院外科重症医学科,西安 710061
脓毒症Toll样受体9生长分化因子15急性肾损伤
sepsisToll-like receptor 9growth differentiation factor 15acute kidney injury
《转化医学杂志》 2026 (1)
1-5,5
陕西省重点研发计划项目(2023-YBSF-421)
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