丛生蛋白与草酸钙肾结石复发的相关性  

Correlation between clusterin expression and recurrence of calcium oxalate kidney stone

作　　者：王琦[1] 刘敏[1] 彭泳涵[1] 李凌[1] 芦超越 周铁[1] 高小峰[1] WANG Qi;LIU Min;PENG Yonghan;LI Ling;LU Chaoyue;ZHOU Tie;GAO Xiaofeng(Department of Urology,Changhai Hospital,Navy Medical University(Second Military Medical University),Shanghai 200433,China)

机构地区：[1]海军军医大学(第二军医大学)长海医院泌尿外科,上海200433

出　　处：《第二军医大学学报》2018年第3期319-323,共5页Academic Journal of Second Military Medical University

基　　金：国家自然科学基金(81370806)~~

摘　　要：目的研究草酸钙肾结石复发的影响因素。方法采集2015年9月至12月于海军军医大学(第二军医大学)长海医院接受住院治疗的草酸钙肾结石患者的临床数据,根据患者发病史分为草酸钙肾结石初发组和复发组。采用酶联免疫吸附试验检测2组患者血液和尿液中丛生蛋白浓度以及血液中炎性指标白细胞介素(IL)-1β、IL-2、IL-6的浓度。采用单因素及多因素回归统计方法分析草酸钙肾结石复发的影响因素。结果 2组各纳入36例患者,单因素分析结果显示2组间年龄、性别、体质量指数(BMI)、肾小球滤过率估计值(e GFR)及结石最大径差异均无统计学意义(P均>0.05);2组间血液丛生蛋白、IL-1β、IL-2及IL-6浓度的差异也均无统计学意义(P均>0.05);复发组尿液丛生蛋白浓度低于初发组[(44.35±15.44)ng/m L vs(56.76±16.80)ng/m L,t=-3.262,P<0.05]。多因素logistic回归分析结果显示,尿液丛生蛋白浓度(OR=0.939,95%CI 0.900~0.979,P<0.05)是草酸钙肾结石复发的独立影响因素。结论草酸钙肾结石复发患者尿液丛生蛋白浓度低于初发患者,提示尿液中丛生蛋白的分泌可能与结石复发有密切关系。Objective To investigate the risk factors influencing the recurrence of calcium oxalate kidney stone.Methods The clinical data of patients with calcium oxalate kidney stone were collected;they were hospitalized in Changhai Hospital,Navy Medical University(Second Military Medical University)from Sep.2015 to Dec.2015.The patients were divided into the first-time calcium oxalate stone group(first-time group)and the recurrent of calcium oxalate stone group(recurrent group)according to the stone histories.The concentrations of clusterin in serum and urine,and the concentrations of serum interleukin(IL)-1β,IL-2 and IL-6 in the two groups were detected by ELISA.The independent risk factors influencing the recurrence of calcium oxalate kidney stones were analyzed by univariate and multivariate logistic regression analysis.Results Thirty-six patients were included in each group.Univariate analysis showed that there were no significant differences in age,gender,body mass index(BMI),estimated glomerular filtration rate(eGFR),maximum stone diameter or the concentrations of serum clusterin,IL-1β,IL-2 and IL-6 between the two groups(all P>0.05).The concentration of urinary clusterin in the recurrent group was significantly lower than that in the first-time group([44.35±15.44]ng/mL vs[56.76±16.80]ng/mL,t=-3.262,P<0.05).Multivariate logistic regression analysis showed that urinary clusterin concentration(OR=0.939,95%CI 0.900-0.979,P<0.05)was an independent risk factor influencing the recurrent of calcium oxalate kidney stone.Conclusion The concentration of urinary clusterin is decreased in patients with recurrence of calcium oxalate stone compared the first-time stone patients,suggesting that the clusterin in urine may be closely related to the recurrence of stones.

关 键 词：肾结石 草酸钙结石 丛生蛋白 氧化应激 炎性反应 复发 

分 类 号：R692.4[医药卫生—泌尿科学]