尿CCL14对脓毒症相关急性肾损伤的预后价值分析
Analysis of the Prognostic Value of Urinary CCL14 in Sepsis-Associated Acute Kidney Injury
DOI: 10.12677/jcpm.2026.51067, PDF,   
作者: 梅亚珍*：济宁医学院临床医学院(附属医院)，山东 济宁；谢颖光#：济宁市第一人民医院重症医学科，山东 济宁
关键词: 尿C-C基序趋化因子配体14；脓毒症；急性肾损伤；Urinary C-C Chemokine Ligand 14； Sepsis； Acute Kidney Injury
摘要: 目的：本研究旨在探讨尿C-C基序趋化因子配体14 (CCL14)对脓毒症相关急性肾损伤(SA-AKI)患者肾功能恢复情况的预测作用。方法：通过筛选2024年7月~2025年6月在济宁市第一人民医院重症医学科收治的患者中符合第28届急性疾病和质量倡议(ADQI)定义的脓毒症相关急性肾损伤的成年患者，并在诊断后的24小时内收集患者尿液，采用酶联免疫吸附法(ELISA)检测尿中CCL14水平，收集临床数据。采用多因素logistic回归分析确定脓毒症相关急性肾损伤预后的危险因素，绘制受试者工作特征曲线(ROC曲线)评估相关指标对预后的预测价值。结果：通过纳入、排除标准最终筛选出120例SA-AKI患者，48例(40%)患者肾功能恢复，72例(60%)患者肾功能未恢复，序贯器官衰竭评估(Sequential Organ Failure Assessment, SOFA)评分、入组肌酐、ICU住院时间、乳酸、利尿剂、血管活性药物、尿CCL14在两组间存在统计学差异(P < 0.05)。患者CCL14水平、SOFA评分对SA-AKI患者肾功能未恢复有一定的诊断价值，受试者工作特征曲线下面积分别为0.904 (95% CI 0.852~0.955)、0.801 (95% CI 0.723~0.879)，尿CCL14诊断效能较好。结论：尿CCL14是脓毒症相关AKI的独立危险因素，并且对SA-AKI患者肾功能未恢复具有较好的预测价值。
Abstract: Objective: This study aims to investigate the predictive value of urinary C-C chemokine ligand 14 (CCL14) for renal recovery in patients with sepsis-associated acute kidney injury (SA-AKI). Methods: Adult patients meeting the 28th Acute Disease Quality Initiative (ADQI) criteria for SA-AKI, admitted to the Intensive Care Unit of Jining No. 1 People’s Hospital between July 2024 and June 2025, were screened. Urine samples were collected within 24 hours of diagnosis, and urinary CCL14 levels were measured using enzyme-linked immunosorbent assay (ELISA), alongside the collection of clinical data. Multivariate logistic regression analysis was employed to identify risk factors for the prognosis of SA-AKI. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of relevant indicators for prognosis. Results: A total of 120 SA-AKI patients were ultimately enrolled based on the inclusion and exclusion criteria. Among them, 48 patients (40%) experienced renal recovery, while 72 patients (60%) did not. Statistically significant differences (P < 0.05) were observed between the two groups in Sequential Organ Failure Assessment (SOFA) score, enrollment creatinine, ICU length of stay, lactate levels, use of diuretics, use of vasoactive agents, and urinary CCL14 levels. Both urinary CCL14 levels and SOFA score demonstrated diagnostic value for renal non-recovery in SA-AKI patients, with areas under the ROC curve of 0.904 (95% CI: 0.852~0.955) and 0.801 (95% CI: 0.723~0.879), respectively. Urinary CCL14 showed superior diagnostic performance. Conclusion: Urinary CCL14 is an independent risk factor for sepsis-associated AKI and exhibits good predictive value for renal non-recovery in SA-AKI patients.
文章引用：梅亚珍, 谢颖光. 尿CCL14对脓毒症相关急性肾损伤的预后价值分析[J]. 临床个性化医学, 2026, 5(1): 485-492. https://doi.org/10.12677/jcpm.2026.51067

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