慢性肾脏病患者血清HIF-1α、TGF-β1与肾小管间质纤维化及疾病进展的关系  

The relationship between serum HIF-1α,TGF-β1 and renal interstitial fibrosis and disease progression in patients with chronic kidney disease

作　　者：林永强 陈恬恬 王超超 周莹[2] 蔡小巧 姜益 林胜芬 LIN Yong-qiang;CHEN Tian-tian;WANG Chao-chao;ZHOU Ying;CAI Xiao-qiao;JIANG Yi;LIN Sheng-fen(Nephrology Department,Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine,Wenzhou,Zhejiang 325000,China;不详)

机构地区：[1]温州市中西医结合医院肾内科,浙江温州325000 [2]温州医科大学附属第一医院肾内科,浙江温州325000

出　　处：《中华全科医学》2021年第11期1868-1871,1978,共5页Chinese Journal of General Practice

基　　金：浙江省基础公益研究计划项目(LQ19H050002)。

摘　　要：目的探讨血清缺氧诱导因子-1α(HIF-1α)、转化生长因子(TGF-β1)与肾小管间质纤维化(TIF)在慢性肾脏病(CKD)患者中的变化及其对疾病进展预测价值。方法选择2019年1月—2020年12月温州市中西医结合医院肾内科收治的CKD患者158例,根据肾小球滤过率(eGFR)值对CKD患者进行分期:1期(38例)、2期(42例)、3期(30例)、4期(28例)、5期(20例),另选取健康体检者40例为对照组,收集各组临床资料及血液样本,应用酶联免疫吸附法(ELISA)检测CKD患者血清HIF-1α、TGF-β1水平,采用Masson染色评估TIF面积。结果CKD 1~5期患者HIF-1α[依次为(25.48±4.26)ng/mL、(30.98±5.36)ng/mL、(35.88±6.78)ng/mL、(42.25±5.63)ng/mL、(68.96±6.98)ng/mL]、TGF-β1[依次为(3.98±0.36)ng/mL、(5.23±0.45)ng/mL、(6.78±0.63)ng/mL、(8.96±1.52)ng/mL、(12.97±2.98)ng/mL]显著高于对照组[(12.78±0.69)ng/mL和(1.22±0.15)ng/mL,均P<0.05]。经Pearson相关性分析显示,血清HIF-1α、TGF-β1与血清CysC、Scr、TIF面积呈正相关(均P<0.05)。经ROC曲线分析可知,血清HIF-1α、TGF-β1联合诊断可提高TIF诊断灵敏性及特异性。结论血清HIF-1α、TGF-β1水平升高与CKD病情进展及肾间质纤维化相关,并可作为CKD患者TIF病情诊断的预测指标,两者联合检测可提高诊断准确性。Objective To investigate the changes of serum hypoxia-inducible factor-1α(HIF-1α),transforming growth factor(TGF-β1)and tubular interstitial fibrosis(TIF)in patients with chronic kidney disease(CKD)and their predictive value for disease progression.Methods A total of 158 cases of CKD patients were selected admitted to Department of Nephrology,Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2019 to December 2020.The patients were staged according to the glomerular filtration rate(eGFR)value:stage 1(n=38),stage 2(n=42),stage 3(n=30),stage 4(n=28),stage 5(n=20).Another 40 cases of healthy subjects were selected as control group.The clinical data and blood samples of above groups were collected.The levels of HIF-1αand TGF-β1 were detected with Enzyme-linked immunosorbent assay(ELISA).TIF area was assessed with Masson staining.Results The levels of HIF-1α[(25.48±4.26)ng/mL,(30.98±5.36)ng/mL,(35.88±6.78)ng/mL,(42.25±5.63)ng/mL,(68.96±6.98)ng/mL],TGF-β1[(3.98±0.36)ng/m,(5.23±0.45)ng/m,(6.78±0.63)ng/m,(8.96±1.52)ng/m,(12.97±2.98)ng/mL]of CKD stage 1-5 were significantly higher than control group[(12.78±0.69)ng/mL and(1.22±0.15)ng/mL,all P<0.05].The levels of serum CysC,Scr,HIF-1α,and TGF-β1 of non-TIF group were lower than TIF group(all P<0.05).The serum HIF-1α,TGF-β1 were positively correlated with serum CysC,Scr,TIF area by Pearson correlate factor analysis(all P<0.05).The HIF-1αand TGF-β1 can improve the value of early CKD diagnosis by receiver specific curve(ROC).Conclusion The increase of serum HIF-1αand TGF-β1 levels is related to the increase of CysC,Scr and TIF.The serum HIF-1αand TGF-β1 can be used as early CKD serum standards,and the combined detection of the two can improve the diagnostic accuracy.

关 键 词：慢性肾脏病 血清缺氧诱导因子-1α 转化生长因子 肾小管间质纤维 疾病进展 

分 类 号：R692[医药卫生—泌尿科学] R692.6[医药卫生—外科学]