Impact of sepsis on the urinary level of interleukin-18 and cystatin C in critically ill neonates
Impact of sepsis on the urinary level of interleukin-18 and cystatin C in critically ill neonates
复制标题
脓毒症对危重新生儿尿白细胞介素18和胱抑素C水平的影响
DOI：
10.1007/s00467-012-2285-7
复制
发表时间：
2013-01-01
影响因子：
3
通讯作者：
Xiao, Zhihui
中科院分区：
文献类型：
--
作者：
Li, Yanhong;Li, Xiaozhong;Xiao, Zhihui
背景尿白细胞介素 18 (uIL-18) 和胱抑素 C (uCysC) 是急性肾损伤 (AKI) 的生物标志物。我们假设，在非 AKI 新生儿中，脓毒症患者的 uIL-18 和 uCysC 水平高于未患脓毒症的新生儿。本研究的目的是确定非 AKI 危重新生儿尿液生物标志物与脓毒症之间的关联，并评估 uIL-18 和 uCysC 是否可以作为该人群脓毒症的预测因子。 方法该研究包括 111 名临床急性恶化提示脓毒症的非 AKI 危重新生儿：26 名感染，57 名未感染，28 名被分配到 未分类组。收集尿液样本并在入组时进行全面的脓毒症筛查。结果非 AKI 脓毒症新生儿中 uIL-18 水平显着升高，但 uCysC 水平没有显着升高。通过多变量分析评估，尿液 IL-18 是与脓毒症相关的独立因素，优势比为 1.73（95% CI 1.15 至 2.58，p= 0.008），预测非 AKI 危重新生儿脓毒症的受试者工作特征曲线下面积为 0.74。结论脓毒症对 uIL-18 水平有影响，但不是在 非 AKI 新生儿中存在 uCysC，表明全身感染可能会影响 uIL-18 在一般人群中检测 AKI 的诊断价值。
BackgroundUrinary interleukin-18 (uIL-18) and cystatin C (uCysC) are biomarkers of acute kidney injury (AKI). We hypothesized that in non-AKI neonates, the level of uIL-18 and uCysC would be higher in those with sepsis compared to those without sepsis. The aims of this study were to determine the association between urinary biomarkers and sepsis in non-AKI critically ill neonates, and to evaluate whether uIL-18 and uCysC could serve as predictors of sepsis in this population.MethodsThe study included 111 non-AKI critically ill neonates with acute clinical deterioration suggestive of sepsis: 26 with infection, 57 without infection, and 28 were assigned to the unclassified group. Urinary samples were collected and a full sepsis screen was performed at the time of enrollment.ResultsThe level of uIL-18, but not uCysC, was significantly elevated in non-AKI septic neonates. Urinary IL-18 was an independent factor associated with sepsis assessed by multivariate analysis, had odds ratio of 1.73 (95 % CI 1.15 to 2.58,p= 0.008), and achieved the area under the receiver operating characteristic curve of 0.74 for predicting the presence of sepsis in non-AKI critically ill neonates.ConclusionsSepsis has an impact on the level of uIL-18, but not on the uCysC in non-AKI neonates, suggesting systemic infection might influence the diagnostic value of uIL-18 to detect AKI in the general population.