Relationship between partial activated thromboplastin time, lactate dehydrogenase-1, neutrophils and rhabdomyolysis associated acute kidney injury in exertional heat stroke patients
10.3760/cma.j.issn.1671-0282.2025.03.018
- VernacularTitle:部分活化凝血活酶时间、乳酸脱氢酶-1及中性粒细胞在劳力型中暑合并横纹肌溶解所致急性肾损伤的相关性分析
- Author:
Jingrong DAI
1
;
Hui LI
;
Bin LIU
Author Information
1. 长沙市第一医院（中南大学湘雅医学院附属长沙医院）全科医学科，长沙 410005
- Keywords:
exertional heat stroke;
Rhabdomyolysis;
Acute kidney injury;
Partially activated thromboplastin time;
Lactate dehydrogenase-1;
Neutrophils
- From:
Chinese Journal of Emergency Medicine
2025;34(3):404-410
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between partial activated thromboplastin time (APTT), lactate dehydrogenase-1 (LDH-1), neutrophil (NEU) and rhabdomyolysis (RM) -associated acute kidney injury (AKI) in exertional heat stroke (EHS) patients.Methods:The valid data of 261 EHS patients hospitalized in the General Hospital of the Southern Theater Command of the PLA from May 2008 to November 2019 were respectively included as the study objects, including 147 patients with RM. Basic data and peripheral blood indexes of the patients were collected, and the patients with RM were divided into non-AKI group and AKI group according to whether they had AKI. Binary Logistic regression was used to analyze the independent influencing factors of RM combined with AKI, and ROC curve was used to analyze the predictive value of relevant indicators on RM concurrent AKI.Results:Among 147 patients with RM, 57 (38.8%) had AKI. Using whether RM was combined with AKI as the dependent variable, variables showing statistical significance ( P<0.05) in univariate analysis were included as independent variables. Model 1 was established through binary logistic regression analysis, while Model 2 was derived using forward selection. The results of Model 2 revealed that NEU ( OR=1.196, 95% CI: 1.082-1.322, P<0.05), LDH-1 ( OR=1.015, 95% CI: 1.005-1.024, P<0.05), and APTT ( OR=1.013, 95% CI: 1.004-1.022, P<0.05) were independent risk factors for RM patients complicated with AKI ( all P<0.05). The AIC value for Model 1 was 166.914, while that for Model 2 was 150.276, indicating that Model 2 outperformed Model 1. The predictive value of NEU, LDH-1 combined with APTT for RM complicated by AKI: The area under the ROC curve (AUC) was 0.830 (95% CI: 0.764-0.897). When the critical value is ≥0.387, it indicates RM complicated by AKI, with a specificity of 0.719 and a sensitivity of 0.811. Conclusions:NEU, LDH-1 and APTT are closely related to AKI in RM, and the combined detection of NEU, LDH-1 and APTT is helpful for early diagnosis of AKI in RM.
