肾小球疾病患者尿液中血管抑素的检测及其临床意义  

Detection and Clinical Significance of Angiostatin in Urine of Patients with Glomerular Disease

作　　者：夏园园 张琦[1] 王思扬 刘洁琼 张雪光[1] 蔡广研[1] 陈香美[1] 

机构地区：[1]解放军总医院肾脏病科,解放军肾脏病研究所,肾脏疾病国家重点实验室,国家慢性肾病临床医学研究中心,北京100853

出　　处：《中国中西医结合肾病杂志》2017年第3期209-212,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：国家科技支撑计划项目(No.2015BAI12B06;2011BAI10B03);国家"973"计划项目(No.2013CB530805);"863"项目(No.2012AA02A512);国家自然科学基金资助项目(No.81171645)

摘　　要：目的:本研究通过检测原发性肾小球疾病患者尿上清中血管抑素的表达水平,以评价其临床意义及反映肾间质纤维化的作用。方法:收集124例原发性肾小球疾病患者肾穿前晨尿,并收集40例健康人晨尿为健康对照组,使用酶联免疫吸附实验(ELISA)技术检测尿上清中血管抑素的浓度,进行组间比较,并与尿蛋白、肾功能等临床指标及病理纤维化指标进行相关分析。结果:与健康对照组[38.57 ng/ml,四分位数间距(IQR):37.85~39.84 ng/ml]相比,疾病组尿上清血管抑素明显升高(81.01,IQR46.58~274.40 ng/ml,P<0.001)。ROC曲线分析显示,尿血管抑素区分疾病组与健康对照的ROC曲线下面积(AUC)为0.926。尿血管抑素与蛋白尿呈正相关,与eGFR呈负相关。CKD3~5期尿血管抑素水平明显高于CKD1期和CKD2期(P均<0.05);肾间质纤维化重度者尿血管抑素水平明显高于轻度者(P<0.01)。结论:尿上清血管抑素可作为反映原发性肾小球疾病患者临床病情及病理间质纤维化严重程度的无创生物标志物。Objective：This study aimed to evaluate the value of urine supernatant angiostatin levels in order to assess its role in disease severity and tubulointerstitial leion of primary glomerular disease. Methods：Urine samples were collected from 124 pa- tients with different glomerular diseases and 40 healthy individuals. Levels of urinary angiostatin were measured by the enzyme - linked immunesorbent experiment （ELISA）. Clinical and pathological correlation analysis were performed. Results：Urinary angiosta- tin levels were significantly higher in patients with glomerular diseases than healthy controls （81.01, IQR 46.58 -274.40 ng/ml vs 38.57 ng/ml, IQR 37.85 ~ 39.84 ng/ml, P 〈 0.001 ）. Concentrations of urinary angiostatin were used to generate ROC curves to evaluate the predictive capability for primary glomerular disease. Results showed that areas under the ROC curves （AUCs） were 0.926. Urine angiostatin levels were correlated positively with proteinuria and negatively with eGFR level. Compared with CKD stages 1 and 2, levels of urinary angiostafin were significantly devated in patients with CKD stages 3 -5 （P 〈 0.01, respectively）. Urine angiostatin levels were increased significantly in patients with severe interstitial fibrosis than those with mild to moderate fibrosis（P 〈 0.01 ）. Conclusion： Urinary angiostatin may be a useful non - invasive biomarker to evaluate clinical condition and tubulointerstitial fibrosis in patients with primary glomerular disease.

关 键 词：血管抑素 原发性肾小球疾病 蛋白尿 CKD分期 间质纤维化 

分 类 号：R692.6[医药卫生—泌尿科学]