| 血清CysC、KIM-1与肾癌患者腹腔镜下保留肾单位肿瘤切除术后急性肾损伤及预后的关系 |
| 投稿时间：2025-04-03 修订日期：2025-05-09 点此下载全文 |
| 引用本文：管庆军,张楠,陈昆,赵阳,张海波,钱小磊.血清CysC、KIM-1与肾癌患者腹腔镜下保留肾单位肿瘤切除术后急性肾损伤及预后的关系[J].医学研究杂志,2025,54(9):103-108 |
| DOI：
10.11969/j.issn.1673-548X.2025.09.018 |
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| 基金项目:河南省医学科技攻关计划项目(LHGJ20191075) |
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| 中文摘要:目的 探索血清胱抑素C(cystatin C,CysC)、肾损伤因子-1(kidney injury molecule-1,KIM-1)与肾癌患者腹腔镜下保留肾单位肿瘤切除术(laparoscopic nephron sparing surgery,LNSS)后急性肾损伤(acute kidney injury,AKI)及预后的关系。方法 收集于河南中医药大学第五临床医学院(郑州人民医院)接受LNSS的62例肾癌患者,采用免疫比浊法、酶联免疫吸附法检测血清CysC及KIM-1水平；依据术后是否发生AKI及复发,将患者分为非AKI组(n=34)和AKI组(n=28)以及预后良好组(n=45)和预后不良组(n=17)；采用单因素和多因素Logistic回归分析AKI及预后不良的影响因素；采用受试者工作特征(receiver operating characteristic,ROC)曲线分析CysC、KIM-1对AKI及预后不良的预测价值。结果 非AKI组和AKI组患者的性别、高血压、糖尿病、手术时间、肾小球过滤率(glomerular filtration rate,GFR)、肾动脉阻断时间及KIM-1水平比较,差异有统计学意义(P<0.05)；预后良好组和预后不良组患者的肿瘤直径、分级、淋巴结转移、CysC及KIM-1水平比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,性别、糖尿病、GFR、肾动脉阻断时间及KIM-1水平是AKI的独立危险因素,GFR是AKI的独立保护因素(P<0.05)；肿瘤直径、血清CysC及KIM-1水平是预后不良的独立危险因素(P<0.05)。ROC曲线分析显示,KIM-1预测AKI的曲线的下面积(area under the curve,AUC)是0.687；CysC、KIM-1预测预后不良的AUC分别为0.829及0.871。结论 血清KIM-1是肾癌患者LNSS后发生AKI的独立危险因素,血清CysC及KIM-1是预后不良的独立危险因素。 |
| 中文关键词:CysC KIM-1 腹腔镜下保留肾单位肿瘤切除术 急性肾损伤 预后 |
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| Relationship between Serum Cystatin C, KIM-1 and Acute Kidney Injury and Prognosis after Laparoscopic Nephron Sparing Surgery in Patients with Renal Cell Carcinoma |
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| Abstract:Objective To explore the relationship between serum CysC, KIM-1 and acute kidney injury (AKI) and prognosis in patients with renal cell carcinoma after laparoscopic nephron sparing surgery (LNSS). Methods A total of 62 patients with renal cell carcinoma who underwent LNSS in our hospital were collected. Serum CysC and KIM-1 levels were detected by immunoturbidimetry and enzyme-linked immunosorbent assay, respectively. According to whether AKI occurred and recurrence after surgery, the patients were divided into the non-AKI group (n=34) and AKI group (n=28), as well as the good prognosis group (n=45) and poor prognosis group (n=17). Univariate and multivariate Logistic regression were used to analyze the influencing factors of AKI and poor prognosis. The predictive value of CysC and KIM-1 for AKI and poor prognosis was analyzed by the receiver operating characteristic (ROC) curve. Results There were significant differences in gender, hypertension, diabetes, operation time, glomerular filtration rate (GFR), renal artery occlusion time and KIM-1 level between the non-AKI group and AKI group (P<0.05). There were significant differences in tumor diameter, grade, lymph node metastasis, CysC and KIM-1 level between the good prognosis group and poor prognosis group (P<0.05). Multivariate Logistic regression showed that gender, diabetes, GFR, renal artery occlusion time and KIM-1 level were independent risk factors for AKI while GFR was an independent protective factor for AKI (P<0.05); tumor diameter, serum CysC and KIM-1 level were independent risk factors for poor prognosis (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of KIM-1 for predicting AKI was 0.687; The AUC of CysC and KIM-1 for predicting poor prognosis were 0.829 and 0.871, respectively. Conclusion Serum KIM-1 is an independent risk factor for AKI after LNSS in patients with renal cell carcinoma, and serum CysC and KIM-1 are independent risk factors for poor prognosis. |
| keywords:CysC KIM-1 Laparoscopic nephron sparing surgery Acute kidney injury Prognosis |
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