Sepsis is one of the common death factors in intensive care unit, which refers to the systemic inflammatory response syndrome caused by infection. It has many complications such as acute renal injury, shock, multiple organ dysfunction, and failure. The mortality of acute renal injury is the highest among the complications, which is a serious threat to the safety of patients and affects the quality of life. This study aimed to observe the changes in autophagy-related protein expressions in patients with acute kidney injury (AKI) after continuous renal replacement therapy (CRRT) and their impacts on prognosis. 207 AKI patients visiting the Emergency Department of The First People’s Hospital of Xuzhou from January 2014 to February 2018 were recruited and treated with CRRT. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was applied to detect the expression of autophagy-related genes, including light chain 3 type II (LC3-II), autophagy-related 5 (Atg-5) and Beclin-1, in the monocytes of the patient’s peripheral blood before and after treatment. The levels of inflammatory mediators interleukin (IL)-1β and IL-6 were determined via enzyme-linked immunosorbent assay before and after treatment. The patient’s serum creatinine (Scr) level before and after treatment was measured using a full-automatic biochemistry analyser. Moreover, the treatment effect was graded after CRRT, and the relationship between the prognosis of patients and the autophagy-related proteins was observed. The Scr levels in the patients were significantly decreased after treatment with CRRT. Before treatment, the IL-1β and IL-6 blood levels were high in the patients, while the amounts were significantly reduced after CRTT. The expressions of LC3-II, Atg-5 and Beclin-1 in the monocytes of patients after treatment were significantly decreased compared with those before treatment. Compared with those in survived patients, the expression of autophagy-related proteins was significantly elevated in in patients died after one to three weeks after the treatment. IL-1β, IL-6, LC3-II and Beclin-1, but not Atg-5 values were significantly correlated with Scr. The expression of LC3-II, Atg-5 and Beclin-1 in the monocytes of patients may change prominently after treatment with CRRT, so they are expected to be regarded as new prognostic indicators for AKI patients.

中文翻译：

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CRRT治疗AKI患者自噬相关蛋白表达变化及其对成人和老年患者预后的影响

脓毒症是重症监护室常见的死亡因素之一，是指感染引起的全身炎症反应综合征。它有许多并发症，如急性肾损伤、休克、多器官功能障碍和衰竭。急性肾损伤在并发症中死亡率最高，严重威胁患者生命安全，影响生活质量。本研究旨在观察急性肾损伤（AKI）患者连续肾脏替代治疗（CRRT）后自噬相关蛋白表达的变化及其对预后的影响。招募 2014 年 1 月至 2018 年 2 月在徐州市第一人民医院急诊科就诊的 207 名 AKI 患者，接受 CRRT 治疗。定量逆转录聚合酶链反应（qRT-PCR）用于检测自噬相关基因的表达，包括轻链3型II（LC3-II）、自噬相关5（Atg-5）和Beclin-1，在治疗前后患者外周血单核细胞。治疗前后通过酶联免疫吸附法测定炎症介质白细胞介素（IL）-1β和IL-6的水平。使用全自动生化分析仪测量患者治疗前后的血清肌酐（Scr）水平。此外，对CRRT后的治疗效果进行分级，观察患者预后与自噬相关蛋白的关系。CRRT治疗后患者的Scr水平显着降低。治疗前，患者的IL-1β和IL-6血液水平较高，而CRTT后水平显着降低。治疗后患者单核细胞中LC3-II、Atg-5和Beclin-1的表达较治疗前明显降低。与存活患者相比，治疗后1-3周后死亡的患者自噬相关蛋白表达明显升高。IL-1β、IL-6、LC3-II 和 Beclin-1，但不是 Atg-5 值与 Scr 显着相关。CRRT治疗后患者单核细胞中LC3-II、Atg-5和Beclin-1的表达可能发生显着变化，有望成为AKI患者新的预后指标。治疗后患者单核细胞中LC3-II、Atg-5和Beclin-1的表达较治疗前明显降低。与存活患者相比，治疗后1-3周后死亡的患者自噬相关蛋白表达明显升高。IL-1β、IL-6、LC3-II 和 Beclin-1，但不是 Atg-5 值与 Scr 显着相关。CRRT治疗后患者单核细胞中LC3-II、Atg-5和Beclin-1的表达可能发生显着变化，有望成为AKI患者新的预后指标。治疗后患者单核细胞中LC3-II、Atg-5和Beclin-1的表达较治疗前明显降低。与存活患者相比，治疗后1-3周后死亡的患者自噬相关蛋白表达明显升高。IL-1β、IL-6、LC3-II 和 Beclin-1，但不是 Atg-5 值与 Scr 显着相关。CRRT治疗后患者单核细胞中LC3-II、Atg-5和Beclin-1的表达可能发生显着变化，有望成为AKI患者新的预后指标。在治疗后一到三周后死亡的患者中，自噬相关蛋白的表达显着升高。IL-1β、IL-6、LC3-II 和 Beclin-1，但不是 Atg-5 值与 Scr 显着相关。CRRT治疗后患者单核细胞中LC3-II、Atg-5和Beclin-1的表达可能发生显着变化，有望成为AKI患者新的预后指标。在治疗后一到三周后死亡的患者中，自噬相关蛋白的表达显着升高。IL-1β、IL-6、LC3-II 和 Beclin-1，但不是 Atg-5 值与 Scr 显着相关。CRRT治疗后患者单核细胞中LC3-II、Atg-5和Beclin-1的表达可能发生显着变化，有望成为AKI患者新的预后指标。