慢性心力衰竭患者尿液肾损伤分子-1的检测及意义  

Significance of urine kidney injury molecule-1 in patients with chronic heart failure

作　　者：吴君[1] 邓根群[1] 李永旺[2] 钟雪焱[2] 

机构地区：[1]大连市中心医院,辽宁大连116033 [2]大连市友谊医院

出　　处：《临床心血管病杂志》2016年第2期166-169,共4页Journal of Clinical Cardiology

摘　　要：目的:检测慢性心力衰竭(心衰)患者尿液肾损伤分子-1(KIM-1)的水平,探讨KIM-1水平与心功能、心衰严重程度、肾功能之间的关系。方法:选取慢性心衰患者60例为慢性心衰组,对照组为我院体检中心的健康对照者30例。所有入选者均行左室射血分数(EF),肾小球滤过率(eGFR),血浆N端B型脑钠肽前体(NTpro-BNP),尿白蛋白排泄率(ACR)和KIM-1检测。结果:与对照组相比,慢性心衰组患者尿KIM-1水平显著升高(P<0.05)。将患者按EF≥40%和EF<40%分组发现,EF<40%组患者尿KIM-1水平显著高于EF≥40%组(P<0.05),2组均显著高于对照组(P<0.05)。另外,研究发现尿KIM-1水平与NT-pro-BNP水平呈正相关(r=0.45,P<0.05);与EF呈负相关(r=-0.38,P<0.05),慢性心衰组患者尿KIM-1水平与Scr无显著相关性(r=0.11,P>0.05);与eGFR无显著相关性(r=-0.13,P>0.05)。尿KIM-1水平与ACR水平显著正相关(r=0.42,P<0.05)。结论:肾功能正常的慢性心衰患者尿KIM-1水平显著升高,与心功能和心衰的严重程度密切相关。提示慢性心衰患者存在肾小管损伤,并且尿KIM-1水平可以间接反映慢性心肾综合征的严重程度。Objective：To detect the level of urine kidney injury molecule-1（KIM-1）in patients with chronic heart failure（CHF）and research the correlation among heart function,severity of CHF and renal function.Method：Sixty chronic heart failure cases were collected from January to June 2013 in cardiovascular department of our hospital.The control group of 30 patients came from healthy subjects in our hospital medical centers.All patients underwent examination of left ventricular ejection fraction（EF）,glomerular filtration rate,plasma N terminal B type natriuretic peptide precursor,urinary albumin excretion rate and kidney injury molecule-1examination.Result：Compared with healthy controls,the level of KIM-1was significantly increased in patients with chronic heart failure（P〈0.05）.We divided patients into two group with EF ≥40% and EF〈40% and found that the level of urine KIM-1in the EF〈40% group was significantly higher than that in the EF≥40% group.Furthermore,the level of urine KIM-1in both patients group was significantly higher than that in healthy control group.In this study,we found that the level of urinary KIM-1had a positive correlation with NT-pro-BNP（r=0.45,P〈0.05）,and a negative correlation with EF（r=-0.38,P〈0.05）.There was no significant correlation between the levels of urine KIM-1and Scr（r=0.11,P〉0.05）or eGFR（r=-0.13,P〉0.05）in chronic heart failure patients.At the same time,there was a significant positive correlation between the level of urine KIM-1and ACR（r=0.42,P〈0.05）.Conclusion：In CHF patients with normal renal function,the level of KIM-1increased significantly and is closely related to the severity of heart function and heart failure.Renal tubular damage exists in the early stage of CHF and the level of urine KIM-1can indirectly reflect the severity of chronic CRS.

关 键 词：慢性心力衰竭 肾损伤分子-1 心肾综合征 

分 类 号：R541.6[医药卫生—心血管疾病]