尿路生物标志物改善了儿童心脏手术中AKI的预测
Oscar T Deal1,2, Thomas Mitchell2, Amy G Harris1
1Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, United Kingdom.
Frontiers in pediatrics
|April 4, 2025
概括
在接受心脏手术的儿童中,早期发现术后急性损伤 (AKI) 是至关重要的. 尿液生物标志物,特别是乌罗莫杜林和互白素-18,可以在24小时内准确预测AKI,从而能够及时干预.
科学领域:
- 儿科脏病学 儿科脏病学
- 心血管外科心血管外科
- 生物标志物发现发现
背景情况:
- 急性损伤 (AKI) 是儿科先天性心脏病 (CHD) 手术后的重大并发症,导致发病率和死亡率增加.
- 目前用于术后AKI的诊断方法在早期往往不可靠,延迟了关键治疗.
研究的目的:
- 评估炎症和脏生物标志物的有效性,以便在心血管疾病手术后的儿科患者中早期检测AKI.
- 确定可靠的生物标志物,以便及时诊断AKI,以促进早期干预.
主要方法:
- 收集了76名儿科患者的尿液和血清样本,这些患者在心血管疾病纠正手术前和24小时后进行了手术.
- 使用 LASSO 调节的单变量和多变量回归分析来识别关键的 AKI 预测因素.
- 雇佣的接收机操作员曲线分析和启动用于模型验证.
主要成果:
- 在术后尿液中,介质素-18水平升高,而在AKI患者中,尿素水平降低.
- 乌罗摩杜林,白素-18和血清脂肪酸结合蛋白3与AKI有显著的关联.
- 一个使用尿尿摩杜林和介质素-18的化合物模型在预测AKI时表现出高准确性 (AUC0.899,灵敏度0.741,特异性0.913).
结论:
- 在手术后24小时测量尿液中的泌尿素和介质蛋白-18,是预测儿科心脏病患者AKI的有效生物标志物.
- 通过这些生物标志物早期识别AKI可以导致及时干预,并可能减少严重损伤的结果.
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