【摘要】 目的 探讨外周血长链非编码RNA癌易感性候选基因2(lncRNA CASC2)、富含亮氨酸α-2糖蛋白1(LRG1)、脑啡肽原A 119-159(penKid)对脓毒症患者并发急性肾损伤（AKI）的预测价值。方法选取2022年12月至2023年12月西安交通大学第二附属医院收治的118例脓毒症患者为病患组，根据是否发生AKI分为AKI组（n=71）和非AKI组（n=47），另选取本院同期健康体检者为健康组（n=40），比较病患组、健康组一般临床资料、外周血lncRNA CASC2、LRG1、penKid水平，比较AKI组、非AKI组外周血lncRNA CASC2、LRG1、penKid水平。多因素Logistic回归分析脓毒症患者并发AKI的影响因素。采用受试者工作特征（ROC）曲线分析lncRNA CASC2、LRG1、penKid对脓毒症患者并发AKI的预测价值。结果 病患组年龄、凝血酶原时间（PT）、合并糖尿病、血清胱抑素C(CysC)、LRG1、penKid水平高于健康组，lncRNA CASC2、血小板计数（PLT）水平低于健康组，差异有统计学意义（P<0.05）;AKI组PT、CysC、LRG1、penKid水平高于非AKI组，lncRNA CASC2、PLT低于非AKI组，差异有统计学意义（P<0.05）；多因素Logistic回归分析结果显示，LRG1、penKid是脓毒症患者并发AKI的独立危险因素，lncRNA CASC2是其独立保护因素（P<0.05）。ROC曲线结果显示lncRNA CASC2、LRG1、penKid及其联合检测预测脓毒症患者并发AKI的曲线下面积（AUC）分别为0.821、0.872、0.805、0.951，较单一预测，联合预测效能更高（P<0.05）。结论 外周血lncRNA CASC2、LRG1、penKid联合检测对脓毒症患者并发AKI具有较高预测价值，显示出良好临床应用潜力。更多还原

【Abstract】 Objective To investigate the predictive value of peripheral blood long non-coding RNA cancer susceptibility candidate gene 2 (lnc RNA CASC2),leucine-rich α-2 glycoprotein 1 (LRG1) and proenkephalin A 119-159 (pen Kid) in patients with sepsis complicated with acute kidney injury (AKI).Methods A total of 118 patients with sepsis admitted to the Second Affiliated Hospital of Xi’an Jiaotong University from December 2022 to December 2023 were selected as the patient group.They were divided into an AKI group (n=71) and a non-AKI group (n=47) based on the incidence of AKI.Healthy individuals who underwent physical examinations at our hospital during the same period were selected as the health group (n=40).General clinical data,peripheral blood levels of lnc RNA CASC2,LRG1 and pen Kid were compared between the patient group.Additionally,peripheral blood levels of lnc RNA CASC2,LRG1 and pen Kid were compared between the AKI group and the non-AKI group.Multivariate logistic regression was used to analyze the influencing factors of AKI in patients with sepsis.The predictive value of lnc RNA CASC2,LRG1,and pen Kid in patients with sepsis complicated with AKI was assessed using receiver operating characteristic (ROC) curves.Results Age,prothrombin time (PT),diabetes mellitus,serum cystatin C (Cys C),LRG1,and pen Kid levels in the patient group were higher than those in the healthy group,and lnc RNA CASC2 levels and platelet count(PLT) were lower than those in the healthy group,the differences were statistically significant (P<0.05).The levels of PT,Cys C,LRG1,and pen Kid in the AKI group were higher than those in the non-AKI group.Conversely,lnc RNA CASC2 and PLT levels were lower tin the AKI group compared to the non-AKI group,with statistical significance (P<0.05).Multivariate logistic regression analysis showed that LRG1 and pen Kid were independent risk factors for AKI in patients with sepsis,while lnc RNA CASC2 was identified as an independent protective factor (P<0.05).ROC curve results showed that the area under the curve (AUC) of lnc RNA CASC2,LRG1,pen Kid,and their combined detection in predicting AKI in sepsis patients was 0.821,0.872,0.805 and 0.951,respectively.This was higher than of the AUV of single prediction.The combined prediction efficiency was significantly higher (P<0.05).Conclusion The combined detection of lnc RNA CASC2,LRG1,and penKid in peripheral blood has a high predictive value in patients with sepsis complicated by AKI,demonstrating significant potential for clinical application.更多还原