The Study Of Heparin Binding Protein Combined With Procalcitonin In The Early Diagnosis And Prognosis Of Sepsis-induced Acute Kidney Injury

BackgroundAcute kidney injury(AKI)refers to a clinical syndrome caused by the acute decline or loss of renal filtration function in a short period of time caused by different reasons.It is a common critical illness in intensive care unit patients,which can increase the risk of chronic kidney disease and end-stage kidney disease and death.Sepsis refers to the life-threatening organ dysfunction caused by the unbalanced response of the body to infection,and is one of the important causes of AKI in critically ill patients.sepsis-induced acute kidney injury has a high morbidity and high mortality rate,which brings a heavy burden to society and families.Early diagnosis of sepsis-induced acute kidney injury is of great significance for improving the prognosis of patients.At present,some new biomarkers have been found to have certain value for the early diagnosis of acute kidney injury,but there are still few studies on biomarkers in the field of sepsis-induced acute kidney injury Studies have shown that heparin binding protein(HBP)is associated with acute kidney injury induced by sepsis.However,there is no research on the dynamic changes and prognostic value of HBP in patients with sepsis-induced acute kidney injury.ObjectiveObserve the change trend of plasma HBP at different time points in patients with sepsis,compare the diagnostic value of HBP at different time points for sepsis-induced acute kidney injury,and the diagnostic efficacy of HBP combined with procalcitonin on sepsis-induced acute kidney injury.To explore the value of HBP in the early diagnosis and prognosis of sepsis-induced acute kidney injury.MethodsIn this study,48 patients with sepsis who were admitted to the central ICU ward of Henan Provincial People’s Hospital from December 2019 to January 2020 and from December 2020 to January 2021 were selected as the experimental group,and all patients in the group were collected with confirmed pus Blood and urine samples taken at 0h,12 h,24h,and 48 h after toxicosis.Fifty patients with healthy physical examination during the same period served as the control group.According to the2012 version of AKI diagnostic criteria,all enrolled patients were divided into sepsis with AKI group and sepsis without AKI group.Collect basic data,clinical and laboratory data of all enrolled patients,record whether all enrolled patients have AKI and AKI classification within 7 days of enrollment;prognosis within 28 days of enrollment.Enzyme Linked Immunosorbent Assay(ELISA)was used to detect plasma HBP concentration at different time points and observe the trend of HBP changes in patients with sepsis.Results1.There is no significant difference between the experimental group and the control group in terms of age,gender and body mass index(P>0.05).The HBP level of sepsis patients is significantly higher than that of healthy subjects(P<0.05).2.There was no significant difference in age,gender,BMI,hypertension,coronary heart disease,etc.between patients with sepsis-induced acute kidney injury group and non-AKI group.The proportion of patients in the sepsis-related AKI group suffering from respiratory diseases and using mechanical ventilation was higher than that of patients in the non-AKI group.The APACHEⅡ and SOFA scores of patients in the sepsis-induced acute kidney injury group were significantly higher than those in the non-AKI group.Patients in the sepsis-induced acute kidney injury group had longer stays in the ICU than those in the non-AKI group.3.The HBP level of sepsis-induced acute kidney injury patients was significantly higher than that of non-AKI group patients,and the differences were statistically significant at each time point(P<0.05).The HBP level of patients with sepsis-induced acute kidney injury reached the highest peak 12 hours after the diagnosis of sepsis,and then decreased.4.Perform ROC curve analysis on the levels of HBP,CRP and PCT in sepsis-induced acute kidney injury group and non-AKI group.The area under the ROC curve of 12 h plasma heparin-binding protein was 0.807(P<0.05),the best cut-off value was 31.60ng/ml,the sensitivity was 60.0%,and the specificity was94.4%;the area under the ROC curve of procalcitonin was 0.758(P<0.05),the best cut-off value is 1.63ng/ml,the sensitivity is 73.3%,and the specificity is 72.2%;when combined detection of 12 h HBP and procalcitonin,the area under the ROC curve is0.878(P<0.05).5.Seventeen of the 30 sepsis-related AKI patients died.The HBP level of the death group was higher than that of the survival group at all time points,but the difference was not statistically significant(P>0.05).Conclusions1.The HBP level of sepsis patients is higher than that of healthy people;the HBP level of sepsis-induced acute kidney injury patients is significantly higher than that of sepsis patients without AKI.2.12 hours after diagnosis of sepsis HBP and procalcitonin can be used for early diagnosis of sepsis-induced acute kidney injury,and the combined detection of the two can improve the diagnostic efficiency of sepsis-induced acute kidney injury.