Crit Care:伴有AKI的危重患者血清IL-17水平较高且与患者较差预后相关

2022-04-18 MedSci原创 MedSci原创

AKI危重患者与非AKI患者相比,AKI诊断或ICU入院时血清IL-17A水平升高,且与医院死亡率和MAKE独立相关。

动物实验表明拮抗白细胞介素-17 (IL-17)可减轻AKI的严重程度和进展。AKI危重患者中产生IL-17的循环T辅助-17 (TH17)细胞数量增加,提示该途径在人类中也被激活。

近日,危重病医学领域权威杂志Critical Care上发表了一篇研究文章,研究人员的目的是比较伴有AKI和不伴有AKI的危重患者的血清IL-17A水平,并研究其与患者死亡率和主要肾脏不良事件(MAKE)之间的关系。

研究人员对2期或3期AKI及无AKI的ICU患者进行了多中心前瞻性研究。标本采集时间为AKI诊断后24-48 h或ICU入院后(无AKI受试者)[时间点1,T1]和5-7 d[时间点2,T2]。MAKE被定义为死亡、依赖肾脏替代治疗或出院后90天eGFR从基线下降≥30%的复合结局。

该研究共评估了299名患者。T1时IL-17A水平处于三分位最高的患者(相对于较低三分位数的患者)有更高的疾病敏度和共病评分。AKI患者IL-17A水平高于非AKI患者:T1 1918.6 fg/ml (692.0-5860.9) vs 623.1 fg/ml (331.7-1503.4), p < 0.001;T2 2167.7 fg/ml (839.9-4618.9) vs 1193.5 fg/ml (523.8-2198.7), p=0.006。T1时血清IL-17A水平每增加1倍,均与住院死亡风险增加(aOR为1.35, 95%CI: 1.06-1.73)和MAKE (aOR为1.26, 95%CI: 1.02-1.55)独立相关。IL-17A水平处于最高的三分位数(相对于最低的三分位数)也与较高的MAKE风险独立相关(aOR为3.03, 95%CI: 1.34-6.87)。AKI状态对这些关联没有影响。死亡或发生MAKE的患者T2时IL-17A水平显著升高。

由此可见,AKI危重患者与非AKI患者相比,AKI诊断或ICU入院时血清IL-17A水平升高,且与医院死亡率和MAKE独立相关。

原始出处:

Jason A. Collett,et al.Serum IL-17 levels are higher in critically ill patients with AKI and associated with worse outcomes.Critical Care.2022.https://ccforum.biomedcentral.com/articles/10.1186/s13054-022-03976-4

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    2022-04-24 fitness

    司库奇尤单抗

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    2022-04-17 fzwish20000
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    2022-04-17 jjjiang0202

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