狼疮性肾炎患者血清sTM、KIM-1、sCD134水平的表达及临床意义  

The Expression and Clinical Significance of Serum STM, KIM-1 and sCD134 in Patients with Lupus Nephritis

作　　者：蒋丽华 陈欢雪[2] 白怡 吴妍 赵丽萍 JIANG Li-hua;CHEN Huan-xue;BAI Yi;WU Yan;ZHAO Li-ping(Department of Nephrology,Liaohe Oilfield General Hospital Affiliated to Jinzhou Medical University,Panjin,Liaoning,124010,China;Department of Nephrology,Shengjing Hospital Affiliated to China Medical University,Shenyang,Liaoning,110004,China;Department of Critical Medicine,Liaohe Oilfield General Hospital Affiliated to Jinzhou Medical University,Panjin,Liaoning,124010,China;First Department of General Surgery,Panjin Central Hospital,Panjin,Liaoning,124010,China)

机构地区：[1]锦州医科大学附属辽河油田总医院肾内科,辽宁盘锦124010 [2]中国医科大学附属盛京医院肾内科,辽宁沈阳110004 [3]锦州医科大学附属辽河油田总医院重症医学科,辽宁盘锦124010 [4]盘锦市中心医院普外一科,辽宁盘锦124010

出　　处：《现代生物医学进展》2020年第21期4121-4125,共5页Progress in Modern Biomedicine

基　　金：国家自然科学基金面上项目(31571184);辽宁省自然科学基金项目(2013022055)。

摘　　要：目的:研究狼疮性肾炎(LN)患者血清可溶性血栓调节蛋白(sTM)、肾损伤分子-1(KIM-1)及可溶性CD134(s CD134)水平的表达及临床意义。方法:选择2016年12月至2018年12月我院收治的LN患者100例,根据系统性红斑狼疮疾病活动度指数(SLEDAI)将患者分为活动期组(SLEDAI≥10分)56例,非活动期组(SLEDAI<10分)44例。另取同期于我院接受体检的健康志愿者50例记为对照组。比较各组受试者的各项肾功能指标、血清sTM、KIM-1及s CD134水平,分析血清sTM、KIM-1及s CD134水平与肾功能指标的相关性。应用受试者工作特征(ROC)曲线分析血清sTM、KIM-1及s CD134水平在LN诊断中的能效。结果:活动期组血尿素氮(BUN)、血肌酐(Scr)以及红细胞沉降率(ESR)水平均高于非活动期组、对照组,且非活动期组BUN、Scr以及ESR水平均高于对照组(P<0.05)。活动期组血清sTM、KIM-1及s CD134水平均高于非活动期组、对照组,且非活动期组血清sTM、KIM-1及s CD134水平均高于对照组(P<0.05)。经Pearson相关性分析显示,LN患者血清sTM、KIM-1、s CD134水平与患者BUN、Scr、ESR水平呈正相关(P<0.05)。ROC曲线分析显示,sTM最佳临界值为24.46 ng/mL,曲线下面积为0.823;KIM-1最佳临界值为8.27μg/L,曲线下面积为0.823;s CD134最佳临界值为15.25 ng/mL,曲线下面积为0.823。结论:LN患者血清sTM、KIM-1及s CD134水平与患者疾病活动程度密切相关,对LN具有很好的诊断效能,临床可能通过联合检测血清sTM、KIM-1及s CD134水平,为LN的诊断以及疾病活动程度提供评估参考。Objective: To study the expression and clinical significance of serum soluble thrombomodulin(STM), renal injury molecule-1(KIM-1) and soluble CD134(s CD134)in patients with lupus nephritis(LN). Methods: 100 LN patients in our hospital from December 2016 to December 2018 were selected. According to the systemic lupus erythematosus disease activity index(SLEDAI), the patients were divided into active group(SLEDAI≥10 points) 56 cases, inactive group(SLEDAI<10 points) 44 cases. Another 50 healthy volunteers who received physical examination in our hospital in the same period were taken as the control group. The renal function indexes, serum levels of STM, KIM-1 and s CD134 were compared, and the correlation between serum levels of STM, KIM-1 and s CD134 and renal function indexes was analyzed. The energy efficiency of serum STM, KIM-1 and scd134 levels in LN diagnosis was analyzed by ROC curve. Results: The levels of Blood urea nitrogen(BUN), creatinine(SCR) and erythrocyte sedimentation rate(ESR) in the active group were higher than those in the inactive group and the control group(P < 0.05). The serum levels of STM, KIM-1 and s CD134 in the active group were higher than those in the inactive group and the control group, and the serum levels of STM, KIM-1 and scd134 in the inactive group were higher than those in the control group(P < 0.05). The Pearson correlation analysis showed that the serum levels of STM, KIM-1 and s CD134 were positively correlated with the levels of BUN, SCR and ESR(P < 0.05). ROC curve analysis shows that the best critical value of STM was 24.46 ng/m L, the area under the curve was 0.823;the best critical value of KIM-1 was 8.27 μg/L, the area under the curve was 0.823. The best critical value of s CD134 was 15.25 ng/mL, and the area under the curve was0.823. Conclusion: The serum levels of STM, KIM-1 and s CD134 in LN patients are closely related to the disease activity, which has a good diagnostic effect on LN. The combined detection of serum levels of STM, KIM-1 and s CD134 may provide

关 键 词：狼疮性肾炎 可溶性血栓调节蛋白 肾损伤分子-1 可溶性CD134 临床意义 

分 类 号：R593.242[医药卫生—内科学]