摘要
目的 探讨血清神经导向因子-1(Netrin-1)、结缔组织生长因子(CTGF)对肾结石经输尿管软镜碎石术后肾损伤的预测价值。方法 2020年3月~2022年3月我院收治的肾结石病人104例,均采用经输尿管软镜碎石术治疗,选取同期我院健康体检者98例为对照组。将输尿管软镜碎石术后肾结石病人分为肾损伤组(58例)和非肾损伤组(46例)。使用酶联免疫吸附法(ELISA)检测血清Netrin-1、CTGF的表达水平。采用单因素分析及多因素Logistic回归分析肾结石经输尿管软镜碎石术后出现肾损伤的影响因素,采用受试者工作特性(ROC)曲线评估血清Netrin-1、CTGF对肾结石经输尿管软镜碎石术后肾损伤的预测价值。结果 研究组血清Netrin-1、CTGF表达水平均高于对照组;肾损伤组血清Netrin-1、CTGF水平高于非肾损伤组;多因素Logistic回归分析显示,Netrin-1≥300 ng/L、CTGF≥0.80 ng/L是输尿管软镜碎石术后肾损伤的危险因素(P<0.05)。血清Netrin-1、CTGF在预测经输尿管软镜碎石术后肾结石病人发生肾损伤的AUC分别为0.731(95%CI:0.668~0.813)、0.845(95%CI:0.798~0.892),两者联合预测的AUC为0.903(95%CI:0.852~0.955)。结论 血清Netrin-1、CTGF表达水平升高与输尿管软镜碎石术后出现肾损伤密切相关,可作为评估输尿管软镜碎石术后早期肾损伤生物学指标,且两者联合预测的效能更高。
Objective To explore the predictive value of serum Netrin-1 and connective tissue growth factor(CTGF)for renal injury after flexible ureteroscopic lithotripsy for renal calculi.Methods A total of 104 patients with renal calculi treated in our hospital from March 2020 to March 2022 after flexible ureteroscopic lithotripsy were selected as the research objects,and 98 people who came to our hospital for physical examination during the same period were selected as the control group.According to the inclusion and exclusion criteria of kidney injury,the patients with kidney stones after flexible ureteroscopic lithotripsy were divided into kidney injury group(n=58)and non-kidney injury group(n=46).The levels of serum Netrin-1 and CTGF were detected by enzyme-linked immunosorbent assay(ELISA).Univariate analysis and multiple Logistic regression were used to analyze the influencing factors of kidney injury after ureteral flexible lithotripsy.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum Netrin-1 and CTGF in kidney injury after ureteral flexible lithotripsy.Results The expression levels of Netrin-1 and CTGF in the study group were higher than those in the control group.Serum Netrin-1 and CTGF levels in renal injury group were higher than those in non-renal injury group.Multivariate Logistic regression analysis showed that Netrin-1≥300 ng/L and CTGF≥0.80 ng/L were risk factors for renal injury after ureteral flexible lithotripsy(P<0.05).The AUC of serum Netrin-1 and CTGF in predicting renal injury after ureteral soft lithotripsy were 0.731(95%CI:0.668~0.813)and 0.845(95%CI:0.798~0.892),respectively.The combined forecast AUC was 0.903(95%CI:0.852~0.955).Conclusion The increased expression levels of serum Netrin-1 and CTGF are closely related to kidney injury after ureteral flexible lithotripsy,and can be used as a biological indicator to evaluate early kidney injury after ureteral flexible lithotripsy,and the combination of the two has higher predictive efficacy.
作者
刘蕴锋
孙亚萍
李秉诚
冯元法
曹满超
王风尧
LIU Yunfeng*;SUN Yaping;LI Bingcheng;FENG Yuanfa;CAO Manchao;WANG Fengyao(Department of Urology Surgery,Qingdao Fuwai Cardiovascular Hospital,Qingdao 266000,China;不详)
出处
《临床外科杂志》
2024年第3期314-317,共4页
Journal of Clinical Surgery
基金
青岛市2020年度医药科研指导计划(2020-WJZD088)。
关键词
肾结石
软镜碎石术
神经导向因子-1
结缔组织生长因子
肾损伤
预测
kidney stones
flexible lithotripsy
neural guidance factor-1
connective tissue growth factor
kidney injury
forecasting
