[1]余 清,滕凤猛.不同分期慢性肾脏疾病患者血清检测指标对其治疗和预后临床价值的探讨[J].南京师大学报(自然科学版),2021,(01):99-103.[doi:10.3969/j.issn.1001-4616.2021.01.014]
 Yu Qing,Teng Fengmeng.Discussion on the Clinical Value of Serum Test Indicators for the Treatmentand Prognosis of Patients with Chronic Kidney Disease in Different Stages[J].Journal of Nanjing Normal University(Natural Science Edition),2021,(01):99-103.[doi:10.3969/j.issn.1001-4616.2021.01.014]
点击复制

不同分期慢性肾脏疾病患者血清检测指标对其治疗和预后临床价值的探讨()
分享到:

《南京师大学报(自然科学版)》[ISSN:1001-4616/CN:32-1239/N]

卷:
期数:
2021年01期
页码:
99-103
栏目:
·生物学·
出版日期:
2021-03-15

文章信息/Info

Title:
Discussion on the Clinical Value of Serum Test Indicators for the Treatmentand Prognosis of Patients with Chronic Kidney Disease in Different Stages
文章编号:
1001-4616(2021)01-0099-05
作者:
余 清滕凤猛
南京中医药大学附属医院/江苏省中医院,江苏 南京 210029
Author(s):
Yu QingTeng Fengmeng
Department of Laboratory Medicine,Jiangsu Province Hospital of TCM,Affilitated Hospital of Nanjing University of TCM,Nanjing 210029,China
关键词:
HE4尿素肌酐慢性肾脏疾病分期并发症
Keywords:
HE4ureacreatininechronic kidney diseasecomplications
分类号:
R446.6
DOI:
10.3969/j.issn.1001-4616.2021.01.014
文献标志码:
A
摘要:
探讨不同分期慢性肾脏疾病(chronic kidney disease,CKD)患者血清检测指标对其诊断、治疗以及并发症防治的应用价值. 采用化学发光法和免疫比浊法检测血清尿素、肌酐、尿酸、胱抑素C、视黄醇结合蛋白和人附睾蛋白4,分析不同分期CDK患者血清指标与CDK分期的关系,采用SPSS软件分析各指标与HE4的相关性. 不同分期CKD患者,血清尿素和肌酐各组之间具有明显差异. 尿酸结果发现,CKD 5、CKD 4和CKD 3组与CKD 1-2组相比具有差异,但CKD 5、CKD 4和CKD 3各组之间比较无差异. 不同分期CKD患者血清胱抑素C和视黄醇结合蛋白也具有明显差异; 且随着分期越高,血清各项检测指标越高. 不同分期CKD患者血清HE4表达水平具有明显差异,且不同分期之间具有统计学意义; 且随着慢性肾病分期越高,患者血清HE4水平也越高. 不同分析CKD患者血清HE4与尿素,肌酐,尿酸,胱抑素C、视黄醇结合蛋白和PTH之间的相关性分析发现,血清HE4与UREA、CREA、CysC、RBP和PTH均相关,其相关系数和95%CI分别为0.741 4(0.66~0.80)、0.826 7(0.77~0.87)、0.849 0(0.80~0.89)、0.643 7(0.54~0.73)和0.436 0(0.28~0.57). 但血清HE4与UA相关性较差,其相关系数和95%CI为0.204 3(0.04~0.35). HE4与CREA对慢性肾病分期具有相同的效能,尿素对慢性肾病分析的ROC曲线面积为0.971 2,胱抑素C对慢性肾病分析的ROC曲线面积为0.903 7. HE4可以作为CKD分期辅助诊断指标之一,GFR联合HE4可以更好地知道CKD的分期. 血清PTH可以作为CKD患者肾脏疾病-矿物质-骨代谢异常并发症的监测指标. 不同分期CDK患者血清学指标对疾病的诊断、治疗以及并发症的防治具有重要价值.
Abstract:
To explore the application value of serum test indicators in patients with chronic kidney disease(CKD)at different stages in their diagnosis,treatment and prevention of complications. Chemiluminescence and immunoturbidimetric methods were used to detect serum urea,creatinine,uric acid,cystatin C,retinol binding protein and human epididymal protein 4. The relationship between serum indicators of CDK patients of different stages and CDK stages was analyzed,SPSS software analyze the correlation between each index and HE4. There were significant differences in serum urea and creatinine among CKD patients of different stages. Uric acid results showed that CKD 5,CKD 4,and CKD 3 groups were different from CKD 1-2 groups,but there was no difference between CKD 5,CKD 4,and CKD 3 groups. The serum cystatin C and retinol-binding protein of CKD patients of different stages also have significant differences,and the higher the stage,the higher the serum detection indicators. Serum HE4 expression levels of CKD patients of different stages are significantly different,and there is statistical significance between different stages,and with the higher the stage of chronic kidney disease,the higher the serum HE4 level of patients. Different analysis of the correlation between serum HE4 and urea,creatinine,uric acid,cystatin C,retinol-binding protein and PTH in CKD patients found that serum HE4 is related to UREA,CREA,CysC,RBP and PTH. The correlation coefficient and 95% CI were 0.741 4(0.66-0.80),0.826 7(0.77-0.87),0.849 0(0.80-0.89),0.643 7(0.54-0.73)and 0.436 0(0.28-0.57),respectively. However,the correlation between serum HE4 and UA is poor,and its correlation coefficient and 95% CI are 0.204 3(0.04-0.35). HE4 and CREA have the same effect on chronic kidney disease staging. The ROC curve area of urea analysis of chronic kidney disease is 0.971 2,and the ROC curve area of cystatin C analysis of chronic kidney disease is 0.903 7. HE4 can be used as one of the auxiliary diagnostic indicators of CKD staging. GFR combined with HE4 can better know the staging of CKD. Serum PTH can be used as a monitoring indicator for the complications of kidney disease-mineral-bone metabolism in CKD patients. Serological indicators of CDK patients in different stages are of great value for the diagnosis,treatment and prevention of complications.

参考文献/References:

[1] DELANAYE P. Detection of decreased glomerular filtration rate in intensive care units:serum cystatin C versus serum creatinine[J]. BMC nephrology,2014,15(1):9.
[2]TREIBER M,BALON B P,GORENJAK M. A new serum cystatin C formula for estimating glomerular filtration rate in newborns[J]. Pediatric nephrology,2015,30(8):1297-1305.
[3]史武奇,张芝亚,李冰,等. 血肌酐与胱抑素C在慢性肾脏病诊断及评估肾功能损伤程度中的应用[J]. 解放军医药杂志,2017,29(5):89-92.
[4]程悠悠,黄庆,叶宏伟. NGAL和Cys C对脓毒症相关急性肾损伤的早期诊断学意义[J]. 华南国防医学杂志,2016(8):496-499.
[5]ANA C L M,MARIA I D R,LIDIA R M,et al. Accuracy of serum human epididymis protein 4 in ovarian cancer diagnosis:a systematic review and meta-analysis[J]. International journal of gynecological cancer:official journal of the International Gynecological Cancer Society,2014,24(7):1222-1231.
[6]CHEN Y,CHEN Q,LIU Q,et al. Human epididymis protein 4 expression positively correlated with miR-21 and served as a prognostic indicator in ovarian cancer[J]. Tumor biology,2016,37(6):8359-8365.
[7]李丽,刘芳. HE4与肾纤维化[J]. 中国中西医结合肾病杂志,2014(7):656-658.
[8]NAGY B,KRASZNAI Z T,BALLA H,et al. Elevated human epididymis protein 4 concentrations in chronic kidney disease.[J]. Annals of clinical biochemistry,2012,49(4):377-380.
[9]YUAN T F,LI Y. Human epididymis protein 4 as a potential biomarker of chronic kidney disease in female patients with normal ovarian function[J]. Laboratory medicine,2017,48(3):238-243.

备注/Memo

备注/Memo:
收稿日期:2020-10-15.
基金项目:国家自然科学基金项目(81503299).
通讯作者:滕凤猛,主管技师,研究方向:免疫学. E-mail:tfmbbmc@126.com
更新日期/Last Update: 2021-03-15