2026 年第 4 期 第 21 卷

血清脂蛋白相关磷脂酶A2和基质金属蛋白酶组织抑制因子2及肾损伤分子1水平在急性肾损伤中的表达及与预后的相关性

Expression of serum lipoprotein-associated phospholipase A2, tissue inhibitor of matrix metalloproteinase 2 and kidney injury molecule 1 in acute kidney injury and their correlation with prognosis

作者：于冰邹鑫徐龙辉马俊伟刘秀娟

英文作者：Yu Bing Zou Xin Xu Longhui Ma Junwei Liu Xiujuan

单位：中国人民解放军联勤保障部队第九〇八医院肾内科，南昌330001

英文单位：Department of Nephrology the 908th Hospital of the Joint Logistics Support Force of the Chinese People′s Liberation Army Nanchang 330001 China

关键词：急性肾损伤；脂蛋白相关磷脂酶A2；基质金属蛋白酶组织抑制因子2；肾损伤分子1

英文关键词：Acutekidneyinjury;Lipoprotein-associatedphospholipaseA2;Tissueinhibitorofmatrixmetalloproteinase2;Kidneyinjurymolecule1

• 摘要：

• 目的 分析血清脂蛋白相关磷脂酶A2（Lp-PLA2）、基质金属蛋白酶组织抑制因子2（TIMP-2）、肾损伤分子1（KIM-1）水平在急性肾损伤中的表达及与预后的相关性。方法 选取2023年1月至2024年12月中国人民解放军联勤保障部队第九〇八医院收治的102例AKI患者作为研究组。同期选取在本院进行健康体检的100例受试者作为对照组。酶联免疫吸附试验法检测血清Lp-PLA2、TIMP-2、KIM-1水平。对AKI患者进行随访，随访时间为6个月。根据患者随访结束时的肾功能恢复情况将其分为预后良好组和预后不良组。分析血清Lp-PLA2、TIMP-2、KIM-1水平与AKI患者预后的相关性。结果 研究组血清Lp-PLA2、TIMP-2、KIM-1水平均显著高于对照组［（357±52）μg/L比（190±39）μg/L、（216±36）ng/L比（98±21）ng/L、（186±21）ng/L比（75±16）ng/L］（均P＜0.05）。随着AKI分期升高，患者血清Lp-PLA2、TIMP-2、KIM-1水平逐渐升高，不同分期患者间差异均有统计学意义（均P＜0.05）。预后不良组血清Lp-PLA2、TIMP-2、KIM-1水平均显著高于预后良好组［（421±55）μg/L比（313±49）μg/L、（257±39）ng/L比（186±33）ng/L、（226±36）ng/L比（158±28）ng/L］（均P＜0.05）。Pearson相关性分析显示，血清Lp-PLA2、TIMP-2、KIM-1水平与不良预后均呈正相关（r=0.685、0.653、0.724，均P＜0.001）。结论 AKI患者血清Lp-PLA2、TIMP-2、KIM-1水平显著升高，且随着AKI分期的升高而逐渐升高。这三个指标均与AKI患者不良预后呈正相关。

• Objective To analyze the expression of serum lipoprotein-associated phospholipase A2 (Lp-PLA2), tissue inhibitor of matrix metalloproteinase 2 (TIMP-2) and kidney injury molecule 1 (KIM-1) in acute kidney injury (AKI) and their correlation with prognosis. Methods A total of 102 AKI patients admitted to the 908th Hospital of the Joint Logistics Support Force of the Chinese People′s Liberation Army from January 2023 to December 2024 were selected as the study group, and 100 healthy subjects who underwent physical examination during the same period at our hospital were enrolled as the control group. Enzyme-linked immunosorbent assay was used to detect the serum levels of Lp-PLA2, TIMP-2 and KIM-1. The AKI patients were followed up for 6 months, and divided into the good prognosis group and poor prognosis group according to the recovery of renal function at the end of follow-up. The correlation between serum levels of Lp-PLA2, TIMP-2, KIM-1 and prognosis of AKI patients was analyzed. Results The serum levels of Lp-PLA2, TIMP-2 and KIM-1 in the study group were significantly higher than those in the control group ［(357±52)μg/L vs (190±39)μg/L, (216±36)ng/L vs (98±21)ng/L, (186±21)ng/L vs (75±16)ng/L］(all P＜0.05). With the increase of AKI stage, the serum levels of Lp-PLA2, TIMP-2 and KIM-1 gradually increasing, there were statistically significant differences between patients of different stages (all P＜0.05). The serum levels of Lp-PLA2, TIMP-2 and KIM-1 in the poor prognosis group were significantly higher than those in the good prognosis group ［(421±55)μg/L vs (313±49)μg/L, (257±39)ng/L vs (186±33)ng/L, (226±36)ng/L vs (158±28)ng/L］(all P＜0.05). Pearson correlation analysis showed that serum levels of Lp-PLA2, TIMP-2 and KIM-1 were positively correlated with poor prognosis (r=0.685, 0.653, 0.724, all P＜0.001). Conclusion The serum levels of Lp-PLA2, TIMP-2 and KIM-1 in AKI patients are significantly elevated and increase gradually with the progression of AKI stage. All the three indicators are positively correlated with the poor prognosis of AKI patients.