摘要
目的探究尿微量白蛋白联合前体纤维连接蛋白Ⅲ型域包含蛋白5(fibronectin typeⅢdomain-containing protein 5,FNDC5)/鸢尾素(Irisin)对原发性高血压肾损伤的诊断价值。方法选取作者医院2018-06/2021-06月收治的144例原发性高血压患者临床资料,分为原发性高血压组(n=72)和原发性高血压肾损伤组(n=72);同时选取60例临床基本资料相匹配的健康志愿者作为对照组。采用生化法测定尿微量白蛋白、血清FNDC5/Irisin水平。采用受试者工作特征(receiver operating characteristic,ROC)曲线评估尿微量白蛋白及FNDC5/Irisin联合检测对原发性高血压肾损伤的诊断价值。结果原发性高血压肾损伤组患者肾功能血清尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,Scr)、β_(2)-微球蛋白(β_(2)-microglobulin,β_(2)-MG)及尿微量白蛋白水平均显著高于对照组(P均<0.05);其中β_(2)-MG及尿微量白蛋白水平明显高于原发性高血压组(P均<0.05)。原发性高血压肾损伤组患者血清Irisin、FNDC5含量均显著低于对照组和原发性高血压组(P均<0.05);且FNDC5 mRNA水平明显低于对照组和原发性高血压组(P均<0.05)。ROC曲线分析显示,尿微量白蛋白、FNDC5 mRNA和Irisin的曲线下面积(area under the curve,AUC)为0.927、0.831及0.855,联合检测的AUC为0.945,敏感度94.70%,特异度81.10%,对原发性高血压肾损伤的诊断价值优于尿微量白蛋白、FNDC5及Irisin单独检测。结论对于原发性高血压肾损伤的诊断,尿微量白蛋白、FNDC5 mRNA表达和Irisin水平较原发性高血压患者及对照组患者差异显著,具有一定诊断意义,且三者联合诊断优于单一指标检测。
Objective To explore the diagnostic value of urinary microalbumin combined with fibronectin typeⅢdomain-containing protein 5(FNDC5)/Irisin for essential hypertensive nephropathy.Methods Clinical data of 144 patients with essential hypertension admitted to author′s hospital from June 2018 to June 2021 were selected,and those patients were divided into essential hypertension group(n=72)and essential hypertensive nephropathy group(n=72).At the same time,60 healthy volunteers with matched clinical data were selected as the control group.The levels of urinary microalbumin and serum FNDC5/Irisin were determined by biochemical method.The diagnostic value of microalbumin and FNDC5/Irisin in essential hypertensive nephropathy was evaluated by receiver operating characteristic(ROC)curve.Results The levels of blood urea nitrogen(BUN),serum creatinine(Scr),β_(2)-microglobulin(β_(2)-Mg)and urinary microalbumin in essential hypertensive nephropathy group were significantly higher than those in the control group(all P<0.05),β_(2)-MG and urinary microalbumin were significantly higher than those in essential hypertension group(all P<0.05).The serum levels of Irisin and FNDC5 in essential hypertensive nephropathy group were significantly lower than those in control group and essential hypertension group(all P<0.05),and FNDC5 mRNA levels were significantly lower than those in control group and essential hypertension group(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of urinary microalbumin,FNDC5 mRNA and Irisin were 0.927,0.831 and 0.855.And the combined detected AUC was 0.945,the sensitivity was 94.70%,and the specificity was 81.10%.The diagnostic value of essential hypertensive nephropathy was better than that of urine microalbumin,FNDC5 and Irisin alone.Conclusion For the diagnosis of essential hypertensive nephropathy,the levels of microalbumin,FNDC5 mRNA and Irisin in urine are significantly different with essential hypertension patients and healthy volunteers,which has certain diagnostic sign
作者
李光
朱汉东
LI Guang;ZHU Handong(Department of Geriatrics,Wuhan Seventh Hospital,Wuhan Hubei 430071,China)
出处
《华南国防医学杂志》
CAS
2021年第9期625-629,共5页
Military Medical Journal of South China
基金
2019年度第一批联合基金立项项目(WJ2019H018)
