尿肾损伤分子-1水平变化与狼疮肾炎合并肾功能不全患者预后的关系  

Relationship between urinary kidney injury molecule-1 changes and prognosis in patients with lupus nephritis and renal insufficiency

作　　者：姚瑶[1] 林珊[1] 贾俊亚[1] 袁鲁晓[1] 

机构地区：[1]天津医科大学总医院肾内科,300052

出　　处：《实用医学杂志》2012年第6期913-915,共3页The Journal of Practical Medicine

基　　金：国家自然科学基金资助项目(编号:30800529);天津市应用基础及前沿计划(编号:10JCYBJC11700)

摘　　要：目的:观察狼疮肾炎(LN)合并肾功能不全(RI)患者尿中肾损伤分子(KIM-1)变化趋势及临床意义。方法:收集本院LN患者31例,分正常肾功组(A组)、RI+肾功改善组(B组)、RI+肾功未改善组(C组),检测血肌酐(SCr)、尿KIM-1等指标。比较各组尿KIM-1变化,探讨其与肾小球滤过率估计值(eGFR)关系及判断预后价值。结果:入院时三组尿KIM-1较对照组明显增加(P<0.05),B组最高(P<0.001)。14d后B组SCr、eGFR好转时尿KIM-1下降(均P<0.05),尿KIM-1与eGFR负相关(r=-0.385,P=0.048)。ROC曲线分析示尿KIM-1、NAG、GAL、SCr预测LN患者肾功能改善曲线下面积分别为0.93、0.86、0.77、0.57。结论:LN合并RI患者入院时尿KIM-1水平升高与14d内肾功能改善密切相关;合理治疗后,尿KIM-1水平在肾功能明显改善的LN患者中有显著下降;尿KIM-1是预测肾功能改善的准确指标。Objective To investigate urinary kidney injury molecule-1 （KIM-1） changes and its significance in lupus nephritis （LN） patient with renal insufficiency （RI）. Methods Thirty-one LN patients admitted to our hospital were enrolled and divided into normal renal function group （Group A）, RI with improved renal function group （Group B）, RI with unimproved renal function group （Group C）. The level of serum creatinine （SCr）, urinary KIM-1 were detected. We compared the changes of urinary KIM-land its correlation with estimated glomerular filtration rate （eGFR） and value in determining prognosis. Results After admission, urinary KIM-1 of three groups were markedly increased （P 〈 0.05）, with the most significantly increase in group B （P 〈 0.001）. After 14 days, urinary KIM-1 were significantly decreased in group B （P 〈 0.05）. Urinary KIM- 1 was negatively correlated with eGFR （r = -0.385, P = 0.048）. By ROC curve analysis, urinary KIM-1, NAG, GAL and SCr levels predicted the improvement of renal function in LN patients, and showed that the area under the curve were 0.93,0.86,0.77,0.57. Conclusions The level of urinary KIM-1 increased significantly in LN and RI patient whose renal function would improve in 14 days, and decreased accompanied by the improvement of renal function after treatment. Urinary KIM-1 may be very important for the prognosis in LN patients.

关 键 词：狼疮肾炎 肾功能不全 肾损伤分子-1 

分 类 号：R593.242[医药卫生—内科学]