慢性肾脏病患者血清人附睾分泌蛋白4的变化及与肾脏纤维化的关系  

Changes of serum human epididymis protein 4 concentrations in chronic kidney disease and the relationship between serum HE4 and renal fibrosis

作　　者：杨坪臻 韩鸿玲[1] 

机构地区：[1]天津医科大学总医院肾内科,天津300070

出　　处：《临床肾脏病杂志》2016年第2期92-95,共4页Journal Of Clinical Nephrology

摘　　要：目的探讨慢性肾脏病（chronic kidney disease,CKD）患者血清人附睾分泌蛋白4（epididymis gene product4，HE4）的变化以及和肾脏纤维化的关系。方法选取住院女性CKD患者190例，采用ELISA（双抗体夹心法）检测血清HFA，用MDRD公式计算肾小球滤过率。按照美国肾脏病基金会K／DOQI指南分期标准将上述患者分为5组，即CKD1期组、CKD2期组、CKD3期组、CKD4期组、CKD5期组，检测并比较血清HFA的水平。选择其中89例住院接受肾穿刺活检的患者，包括CKD1期组55例，CKD2期组15例，CKD3期组19例；并根据肾组织病理结果分为肾小球硬化组和无肾小球硬化组，分析肾小球硬化与血清HFA的关系。结果不同CKD分期组之间血清HFA水平差异有统计学意义（P〈0．01）。肾功能不全患者（CKD2～5期组）血清HE4水平高于肾功能正常患者（CKD1期组）（P〈0．05），其中CKD2期组血清HE4水平高于CKD1期组（P〈0．01），CKD3期组血清HE4水平高于CKD2期组（P〈0．01），CKD4期组血清HE4水平高于CKD3期组（P〈0．01），CKD5期组血清HE4水平高于CKD4期组（P〈0．01）。肾小球滤过率与血清HE4呈非线性负相关。在CKD1～3期组中血清HFA的水平在肾小球硬化组与无肾小球硬化组之间无统计学差异（P〉0．05）。结论在无妇科肿瘤的女性CKD患者中血清HFA会显著升高，并且HFA的血清水平会随着CKD临床分期的增加而逐渐增高。用HE4辅助诊断妇科肿瘤和评估肿瘤的复发及治疗效果时，应考虑CKD的影响。检测血清HE4水平是否能成为判断无妇科肿瘤的CKD患者肾脏纤维化发生的指标还有待临床研究。Objective To analyze the change of serum human epididymis protein 4 concentra tions in chronic kidney disease and the relationship between serum HE4 and renal fibrosis. Methods Inl90 female patients at different stages of chronic kidney disease （CKD） with no ovarian and lung cancer , HFA concentrations were analyzed by using Enzmy-linked immunosorhent assay （ELISA）. Renal function was evaluated by measuring serum creatinine and urea concentrations. Estimated glomerular filtrationn rate（eGFR） was calculated by the MDRD formula, eighty-nine cases of CKD with stage 1 to 3 were divided into glomerulosclerosis group and no glomerulosclerosis group according to the renal pathological changes. Analyze the relationship between serum HFA and renal fibrosis. Results The levels of serum HFA in CKD group are differences （P〈00. 01）. The levels of serum HFA were significantly higher in the chronic renal insufficiency group （CKD2,CKD3,CKIM,CKD5 groups） than those in normal renal function （P〈0. 05）. The levels of serum HFA were higher in CKDI group than those in CKD2 group （P〈00. 05）, The levels of serum HFA were higher in CKD2 group than those in CKD3 group （P〈0. 001 ）, The levels of serum HFA were higher in CKD3 group than those in CKD4 group （P〈0. 01）, The levels of serum HFA were higher in CKD4 group than those in CKD5 group（P〈0. 001 ）. The relationship between serum HE4 and GFR showed a negative nonlinear correlation. Results Serum HE4 concentrations showed no difference among glomerulosclerosis group and no glomerulosclerosis group （P〈0. 05）. Conclusions HFA concentrations may be elevated in CKD patients with no ovarian and lung cancer. Thus, HE4 results should be interpreted cautiously in women with renal disorders. Whether serum HFA concentrations can become the indicator of renal fibrosis in patients with chronic kidney remains to be clinical research.

关 键 词：慢性肾脏病 人附睾分泌蛋白4 肾脏纤维化 

分 类 号：R692[医药卫生—泌尿科学]