摘要
目的分析肾移植术后慢性肾病(CKD)患者血清人附睾蛋白4(HE4)的水平变化及临床意义。方法选取2014年1月~2019年6月于广东省惠州市中心人民医院及广东省中医院随诊的肾移植术后CKD患者87例作为研究对象(CKD组),另选取广东省惠州市中心人民医院体检的健康者50名作为对照组,比较两组估算的肾小球滤过率(eGFR)及血清中HE4、肌酐(SCr)、尿素氮(BUN)、尿β2微球蛋白(β2-MG)水平,分析HE4与各肾病相关指标的相关性,分析CKD的危险因素,受试者工作特征曲线(ROC)绘制HE4和SCr、BUN、β2-MG对CKD的预测价值。结果 CKD组患者的HE4、SCr、BUN及β2-MG水平明显高于对照组,而eGFR低于对照组(P <0.05)。CKD1期患者HE4水平高于对照组,不同CKD分期HE4水平比较,差异均有统计学意义(均P <0.05);CKD2期患者SCr、BUN、 2-MG水平高于对照组,不同CKD分期SCr、BUN、 2-MG水平比较,差异均有统计学意义(均P <0.05);CKD2期患者eGFR低于对照组,不同CKD分期eGFR比较,差异均有统计学意义(均P <0.05)。CKD组HE4与SCr、BUN及β2-MG呈正相关(r=0.611,0.555,0.539,P <0.05),与eGFR呈负相关(r=-0.762,P <0.05)。Logistic多因素回归分析显示HE4、SCr、BUN及β2-MG水平升高均是CKD的独立危险预测因子(均P <0.05)。HE4预测CKD的ROC曲线下面积为0.877高于SCr(0.785)、BUN(0.752)和β2-MG(0.778),四项指标联合检测CKD的ROC曲线下面积最高,可达0.965。结论肾移植术后CKD患者的血清HE4水平明显升高,对患者发生CKD的预测价值较高,其可辅助临床对肾移植术后患者发生CKD的早期诊断。
Objective To analyze the changes and clinical significance of serum human epididymal protein 4(HE4)in patients with chronic kidney disease(CKD)after kidney transplantation.Methods A total of 87 patients with CKD after kidney transplantation who were followed up in Huizhou Central People′s Hospital and Guangdong Hospital of Traditional Chinese Medicine from January 2014 to June 2019 were selected as the study subjects(CKD group),another 50healthy subjects who underwent physical examination in Huizhou Central People′s Hospital were selected as the control group.The estimated glomerular filtration rate(eGFR)and serum levels of HE4,creatinine(SCr),urea nitrogen(BUN)and urinaryβ2-microglobulin(β2-MG)were compared between the two groups.The correlation between HE4 and various nephropathy-related indicators was analyzed,the risk factors for CKD were analyzed,and the predictive value of HE4,SCr,BUN,andβ2-MG on CKD was plotted by ROC.Results The levels of HE4,SCr,BUN andβ2-MG in patients in the CKD group were significantly higher than those in the control group,while the levels of eGFR were lower than those in the control group(P<0.05).The HE4 level of patients with CKD1 stage was higher than that of the control group,and the difference of HE4 level in different CKD stages was statistically significant(all P<0.05).The levelsof SCr,BUN and 2-MG of CKD stage2 patients were higher than those of the control group,and the differences between SCr,BUN and 2-MG in different CKD stages were statistically significant(all P<0.05).eGFR in patients with stage2 of CKD was lower than that in the control group,and the differences in eGFR in different stages of CKD were statistically significant(all P<0.05).There was an obvious positive correlation between HE4 and SCr,BUN andβ2-MG in CKD group(r=0.611,0.555,0.539,P<0.05),while negatively correlated with eGFR(r=-0.762,P<0.05).Logistic multivariate regression analysis showed that elevated HE4,SCr,BUN andβ2-MG levels were all independent risk predictors of CKD(all P<0.05).HE4 predi
作者
罗伯珣
张卫平
孟凡航
LUO Boxun;ZHANG Weiping;MENG Fanhang(Department of Nephrology,Huizhou Central People′s Hospital,Guangdong Province,Huizhuo 516001,China;Department of Infection Control,Huizhou Central People′s Hospital,Guangdong Province,Huizhuo516001,China;Department of Organ Transplantation,Guangdong Hospital of Traditional Chinese Medicine,Guangdong Province,Guangzhou 510800,China)
出处
《中国医药导报》
CAS
2020年第12期80-84,共5页
China Medical Herald
基金
国家自然科学基金资助项目(81700675)
广东省医学科研基金立项课题(A2013775)
广东省惠州市医疗卫生类科技计划项目立项(2019Y049)。
关键词
肾移植
慢性肾病
人附睾蛋白4
危险因子
预测价值
Kidney transplantation
Chronic kidney disease
Human epididymal protein 4
Risk factors
Predictive value
