【摘要】 目的初步研究α-Klotho蛋白在急性心肌梗死(AMI)致急性肾损伤(AKI)患者的早期应用价值。方法纳入我院经急诊科收治的AMI患者107例,将患者分为AKI组(23例)和无AKI组(84例),于入院当天留取血液标本,利用ELISA法检测患者血清α-Klotho蛋白表达水平,收集患者临床资料,进行统计分析。结果与无AKI组比较,AKI组住院时间显著延长,病死率为26.1%[AKI 1期7.7%(1/13)、2期33.3%(2/6)、3期75.0%(3/4)]。多因素logistic回归分析显示,女性、心率、广泛前壁心肌梗死、LVEF、入院血肌酐、α-Klotho蛋白均有统计学差异(P<0.05,P<0.01)。与无AKI组比较,AKI组α-Klotho蛋白表达显著升高[186.1(136.2,235.1)ng/L vs 99.7(60.4,149.3)ng/L,P<0.01],α-Klotho蛋白ROC曲线下面积为0.778(95%CI:0.676～0.880),诊断AKI特异性0.805,敏感性0.750。结论α-Klotho蛋白可能为AMI患者发生AKI的早期生物学标志物。更多还原

【Abstract】 Objective To study the value of α-Klotho protein in early diagnosis of acute kidney injury(AKI) induced by acute myocardial infarction(AMI).Methods One hundred and seven AMI patients admitted to our hospital from 2015-01-01 to 2015-06-01 were divided into AKI group(n=23) and AKI-free group(n=84).Blood sample was taken on the day after admission and α-Klotho protein expression in two groups was detected by ELISA.The clinical data of two groups were recorded and analyzed.Results The hospital stay time of patients in AKI group was significantly longer than that of those in AKI-free group.The death rate in AKI group was 26.1% [7.7%(1/13) at stage 1 AKI,33.3%(2/6) at stage 2 AKI,75.0%(3/4) at stage 3 AKI].Multivariate logistic regression analysis showed a significant difference in female gender,heart rate,extensive anterior myocardial infarction,LVEF,serum creatinine and α-Klotho protein level on admission between the two groups(P<0.05,P<0.01).The expression level of α-Klotho protein was significantly higher in AKI group than in AKI-free group [186.1(136.2,235.1)ng/L vs 99.7(60.4,149.3)ng/L,P<0.01].The AUC for α-Klotho protein in diagnosis of AKI was 0.778(95%CI:0.676-0.880) with a specificity of 0.805 and a sensitivity of 0.750.Conclusion α-Klotho protein may be an early biomarker of AKI in AMI patients.更多还原