脓毒症患者血清LRG1、suPAR水平对并发急性肾损伤的预测价值

doi:10.11958/20252777

天津医药 ›› 2026, Vol. 54 ›› Issue (4): 374-378.doi: 10.11958/20252777

脓毒症患者血清LRG1、suPAR水平对并发急性肾损伤的预测价值

赵政委¹(), 许文艳¹, 郭晓敏¹, 王敏², 李建丽¹, 李志海³^△(), 沈东琼⁴, 涂云贵¹

¹ 安宁市第一人民医院检验科（邮编650300）
² 安宁市第一人民医院疼痛科（邮编650300）
³ 安宁市第一人民医院超声科（邮编650300）
⁴ 安宁市第一人民医院肾内科（邮编650300）

收稿日期:2025-08-22 修回日期:2025-09-25 出版日期:2026-04-15 发布日期:2026-04-14
通讯作者: ^△E-mail：304489557@qq.com
作者简介:赵政委（1988），男，主管检验师，主要从事血液学方面研究。E-mail：zhaoshunl954590@163.com
基金资助:
昆明市卫生健康委员会卫生科研课题项目(2023-11-01-024)

Predictive value of serum LRG1 and suPAR levels in sepsis patients with concurrent acute kidney injury

ZHAO Zhengwei¹(), XU Wenyan¹, GUO Xiaomin¹, WANG Min², LI Jianli¹, LI Zhihai³^△(), SHEN Dongqiong⁴, TU Yungui¹

¹ Department of Clinical Laboratory, Anning First People's Hospital, Kunming 650300, China
² Department of Pain, Anning First People's Hospital, Kunming 650300, China
³ Department of Ultrasound, Anning First People's Hospital, Kunming 650300, China
⁴ Department of Nephrology, Anning First People's Hospital, Kunming 650300, China

Received:2025-08-22 Revised:2025-09-25 Published:2026-04-15 Online:2026-04-14
Contact: ^△E-mail：304489557@qq.com

赵政委, 许文艳, 郭晓敏, 王敏, 李建丽, 李志海, 沈东琼, 涂云贵. 脓毒症患者血清LRG1、suPAR水平对并发急性肾损伤的预测价值[J]. 天津医药, 2026, 54(4): 374-378.

ZHAO Zhengwei, XU Wenyan, GUO Xiaomin, WANG Min, LI Jianli, LI Zhihai, SHEN Dongqiong, TU Yungui. Predictive value of serum LRG1 and suPAR levels in sepsis patients with concurrent acute kidney injury[J]. Tianjin Medical Journal, 2026, 54(4): 374-378.

摘要/Abstract

摘要：

目的探究脓毒症患者血清富含亮氨酸的糖蛋白α-2糖蛋白1（LRG1）、可溶性尿激酶型纤溶酶原激活物受体（suPAR）水平变化及对并发急性肾损伤（AKI）的预测价值。方法纳入脓毒症患者120例并依据入院1周内是否发生AKI分为AKI组与非AKI组。另纳入同期健康体检者120例作为健康组。采用酶联免疫吸附试验（ELISA）检测血清LRG1、suPAR水平。受试者工作特征（ROC）曲线评估血清LRG1和suPAR对脓毒症相关AKI的预测效能；决策曲线分析法（DCA）分析血清LRG1、suPAR预测脓毒症并发AKI的临床实用性；Logistic回归分析脓毒症并发AKI的影响因素。结果与健康组相比，疾病组血清LRG1和suPAR表达水平升高（P<0.05）。AKI组血管活性药物应用比例、序贯器官衰竭评分、急性生理功能与慢性健康状况评估评分及降钙素原、血乳酸（Lac）、LRG1、suPAR水平均高于非AKI组（P<0.05）。LRG1、suPAR联合预测脓毒症并发AKI的曲线下面积（AUC）为0.850（95%CI：0.773~0.909），均优于LRG1、suPAR单独预测（Z分别为2.185、2.464，均P<0.05），当高风险阈值为0.0~1.0时，二者联合检测预测脓毒症并发AKI的净获益率优于单独检测。LRG1、suPAR、Lac水平升高及使用血管活性药物均为脓毒症并发AKI的独立危险因素。结论血清LRG1、suPAR水平在脓毒症患者中升高，为影响AKI的相关因素，二者联合具有更高预测价值。

关键词: 脓毒症, 急性肾损伤, 受体, 尿激酶型纤溶酶原激活物, ROC曲线, 富含亮氨酸的糖蛋白α-2糖蛋白1

Abstract:

Objective To investigate changes of serum levels of leucine-rich α-2 glycoprotein 1 (LRG1) and soluble urokinase-type plasminogen activator receptor (suPAR) in sepsis patients and their predictive value for concurrent acute kidney injury (AKI). Methods A total of 120 sepsis patients were included and divided into the AKI group and the non AKI group according to whether AKI occurred within one week after admission. Another 120 cases of healthy individuals who underwent physical examinations in the same period were included as the health group. The serum levels of LRG1 and suPAR were detected by enzyme-linked immunosorbent assay (ELISA). Receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of serum LRG1 and suPAR for sepsis-associated AKI. Decision curve analysis (DCA) was used to analyze the clinical utility of serum LRG1 and suPAR in predicting sepsis complicated with AKI. Logistic regression was used to analyze the influencing factors of sepsis complicated with AKI. Results The serum expression levels of LRG1 and suPAR in patients were significantly higher in the disease group than those in the healthy control group (P<0.05). The proportion of vasoactive drug application, sequential organ failure assessment score, acute physiology and chronic health evaluation Ⅱ score, procalcitonin, blood lactate (Lac), LRG1 and suPAR levels were higher in the AKI group than those in the non-AKI group (P<0.05). The area under the curve (AUC) of combined prediction of sepsis complicated with AKI was 0.850 (95%CI: 0.773-0.909), which was better than that of LRG1 or suPAR alone (Z=2.185, 2.464, both P<0.05). When the high risk threshold was 0.0-1.0, the net benefit rate of combined detection of the two tests in predicting sepsis complicated with AKI was better than that of single detection. Increased LRG1 level, increased suPAR level, increased Lac level and the use of vasoactive drugs were independent risk factors for sepsis complicated with AKI. Conclusion Serum LRG1 and suPAR levels are increased in sepsis patients and are related factors affecting AKI. The combination of the two has a higher predictive value.

Key words: sepsis, acute kidney injury, receptors, urokinase plasminogen activator, ROC curve, leucine-rich α-2 glycoprotein 1

中图分类号:

R631.2

图/表 7

参考文献 21

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组别	性别（男/女）	年龄/岁	BMI/（kg/m²）
健康组	63/57	61.25±6.23	21.55±1.93
疾病组	69/51	60.80±5.93	21.63±2.11
t或χ²	0.606	0.573	0.306

组别	性别（男/女）	年龄/岁	BMI/（kg/m²）
健康组	63/57	61.25±6.23	21.55±1.93
疾病组	69/51	60.80±5.93	21.63±2.11
t或χ²	0.606	0.573	0.306

组别	LRG1	suPAR
健康组	179.23±24.33	8.93±2.13
疾病组	249.20±35.47	14.82±2.77
t	17.817^＊＊	18.399^＊＊

组别	LRG1	suPAR
健康组	179.23±24.33	8.93±2.13
疾病组	249.20±35.47	14.82±2.77
t	17.817^＊＊	18.399^＊＊

组别	n	性别		年龄/岁	BMI/（kg/m²）	糖尿病	高血压	冠心病	高脂血症	感染部位
组别	n	男	女	年龄/岁	BMI/（kg/m²）	糖尿病	高血压	冠心病	高脂血症	肺部	泌尿系统	腹腔	其他
非AKI组	67	39（56.52）	28（54.90）	60.75±5.92	21.65±1.88	14（58.33）	20（60.61）	10（58.82）	15（62.50）	25（36.23）	19（67.86）	22（73.33）	1（2.50）
AKI组	53	30（43.48）	23（45.10）	60.87±5.63	21.60±1.94	10（41.67）	13（39.39）	7（41.18）	9（37.50）	21（30.43）	16（57.14）	10（33.33）	6（15.00）
t或χ²		0.031		0.114	0.115	0.076	0.420	0.072	0.541	7.140
组别		机械通气		血管活性药物	APACHEⅡ评分/分	SOFA评分/分	PCT/ （μg/L）		血肌酐/（μmol/L）	Lac/ （mmol/L）		LRG1/ （μg/L）	suPAR/（μg/L）
非AKI组		31（62.00）		26（44.07）	15.48±3.24	6.92±1.95	8.49±1.25		115.44±15.37	1.46±0.28		235.52±30.42	13.62±2.65
AKI组		19（38.00）		33（55.93）	17.22±3.13	8.93±2.15	13.52±2.35		117.65±16.33	1.92±0.43		266.49±32.15	16.34±3.29
t或χ²		1.322		6.515^＊	2.965^＊＊	5.384^＊＊	14.044^＊＊		0.761	6.885^＊＊		5.402^＊＊	5.015^＊＊

脓毒症患者血清LRG1、suPAR水平对并发急性肾损伤的预测价值

Predictive value of serum LRG1 and suPAR levels in sepsis patients with concurrent acute kidney injury

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变量	最佳截断值	AUC	95%CI	敏感度/%	特异度/%	约登指数
LRG1	256.96 μg/L	0.778	0.693~0.849	75.47	85.07	0.606
suPAR	14.69 μg/L	0.772	0.686~0.843	73.58	83.58	0.572
联合检测	-	0.850	0.773~0.909	86.79	71.64	0.584

变量	β	SE	Wald χ²	P	OR	OR 95%CI
LRG1	1.540	0.429	12.888	<0.001	4.665	2.012~10.815
suPAR	1.439	0.372	14.956	<0.001	4.215	2.033~8.739
Lac	1.351	0.354	14.574	<0.001	3.863	1.930~7.731
血管活性药物	1.117	0.288	10.054	<0.001	3.057	1.738~5.376
常数项	-9.287	2.349	10.576	<0.001	0.000	-

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