关键词: 脓毒症, 急性肾损伤, 血管生成素2, 白细胞介素-23

Abstract: Objective To investigate the expression of serum angiopoietin-2 (Ang-2) and interleukin-23 (IL-23) in patients with sepsis and to analyze their relationship with acute kidney injury (AKI) in patients with sepsis. 
Methods A total of 185 patients with sepsis treated in the Affiliated Hospital of Chengde Medical College, Hebei Province, were selected as the research subjects. All patients were treated and divided into AKI group and non-AKI group according to the occurrence of AKI during hospitalization. The levels of serum Ang-2 and IL-23 were detected by enzyme-linked immunosorbent assay (ELISA) at admission, and the baseline data of patients were collected. The serum Ang-2, IL-23 and baseline data were compared between the two groups. Logistic regression analysis was used to test the influencing factors of AKI in patients with sepsis, and then the receiver operating curve (ROC) was drawn to explore the predictive value of serum Ang-2 and IL-23 for AKI in patients with sepsis. 
Results Among 185 patients with sepsis, 87 patients with AKI were diagnosed by blood and urine examination, and the incidence rate was 47.03%. The proportion of patients with combined shock was higher in AKI group than in non-AKI group, and the levels of serum Ang-2 and IL-23 at admission were higher than those in non-AKI group, with significant differences (P＜0.05). The results of binary Logistic regression analysis showed that combined shock, high expression of Ang-2 and IL-23 at admission were risk factors for AKI in patients with sepsis (OR>1, P＜0.05). The ROC curve was drawn, and the results showed that, the area under the ROC curve (AUC) of the levels of serum Ang-2, IL-23 alone and in combination in predicting AKI in patients with sepsis was all >0.70, showing certain predictive value, among which the combined detection was the highest. There was a linear dose-response relationship between the levels of serum Ang-2 and IL-23 and AKI in patients with sepsis (P＜0.05). The levels of serum Ang-2 and IL-23 were positively correlated with AKI in patients with sepsis, especially when serum Ang-2 was >9.23 μg/L and serum IL-23 was >101.97 pg/L. The risk of AKI in patients with sepsis was increased with the increase of serum Ang-2 and IL-23 levels. 
Conclusion Serum Ang-2 and IL-23 are the influencing factors of AKI in patients with sepsis, and the risk of AKI is positively correlated with Ang-2 and IL-23 levels. 

Key words: sepsis, acute kidney injury, angiopoietin-2, interleukin-23