Sema 3A与KIM-1在糖尿病肾病患者病情变化中的意义及与预后关系  

Significance of Sema 3Aand KIM-1in Patients with Diabetic Nephropathy and Its Relationship with Prognosis

作　　者：余永梅[1] 杜曰娟 唐佳信 温泉萍 王彦璎 YU Yongmei;DU Yuejuan;TANG Jiaxin;WEN Quanping;WANG Yanying(Department of Nephrology,Shandong Rongjuo General Hospital,Jinan Shandong 250003,China)

机构地区：[1]山东省荣军总医院肾脏内科,山东济南250003 [2]济南市中心医院肾内科

出　　处：《华南国防医学杂志》2022年第1期41-45,共5页Military Medical Journal of South China

摘　　要：目的分析血清信号素3A(semaphorin 3A,Sema 3A)、肾损伤分子1(kidney injury molecule 1,KIM-1)在糖尿病肾病(diabetic nephropathy, DN)患者病情变化中的意义及与预后的关系。方法选取作者医院2018-08/2020-08月纳入的126例2型糖尿病肾病患者,按照Mogenson分期标准将DN患者分为Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期、Ⅴ期,于临床规范化治疗后采用酶联免疫吸附测定(enzyme-linked immunosorbent assay, ELISA)检测DN患者血清Sema 3A、KIM-1变化,并收集患者相关临床资料。随访1年,根据肾小球滤过率及临床表现将DN患者分为预后良好组、预后不良组。采用单因素分析法分析性别、年龄、血清Sema 3A、KIM-1等可能影响DN患者预后的危险因素。Logistic回归分析明确影响DN患者预后的危险因素。Pearson相关性分析评估血清Sema 3A、KIM-1与DN患者预后的关系。结果通过检测不同病理分期DN患者的血清Sema 3A、KIM-1发现,随着疾病进展,血清Sema 3A、KIM-1表达均有不同程度上调。126例DN患者中预后不良组共54例,预后良好组共72例。预后不良组血清Sema 3A、KIM-1水平分别均高于预后良好组,组间比较有统计学差异(203.24±36.27 vs. 156.39±28.44 ng/ml, 12.54±1.25 vs. 7.63±0.91 ng/ml,P均<0.05)。单因素分析结果显示,两组性别、年龄、体质量指数(body mass index, BMI)、病程、既往病史、入院时血压、部分生化指标水平[血清钙、总胆固醇(total cholesterol, TC)、甘油三酯(triglyceride, TG)、血尿酸(blood uric acid, BUA)、血肌酐(serum creatinine, Scr)、糖化血红蛋白(glycosylated hemoglobin A;c, HbA;c)、血浆前白蛋白(prealbumin, PA)、血磷、血尿素氮(blood urea nitrogen, BUN)]组间差异无统计学意义(P>0.05)。与预后良好组比较,预后不良组DNⅣ及Ⅴ期占比高,尿微量白蛋白(microalbumin, mALB)水平高,血清Sema 3A、KIM-1表达上调,组间比较有统计学差异(P均<0.05)。Logistic回归分析结果显示,DNⅣ及Ⅴ期占�Objective To analyze the significance of serum semaphorin 3 A(Sema 3 A) and kidney injury molecule 1(KIM-1) in patients with diabetic nephropathy(DN) and its relationship with prognosis.Methods A total of 126 DN patients in type 2 diabetes included in the authors′ hospital from August 2018 to August 2020 were selected, and DN patients were divided into stage I, stage Ⅱ, stage Ⅲ, stage Ⅳ, and stage Ⅴ according to the Mogenson staging standard.After clinical standardized treatment, serum Sema 3 A and KIM-1 changes in DN patients were detected by enzyme-linked immunosorbent assay(ELISA), and relevant clinical data of patients were collected.After 1-year follow-up, DN patients were divided into a good prognosis group and a poor prognosis group based on the glomerular filtration rate and clinical manifestations. The risk factors that might affect the prognosis of DN patients, such as gender, age, serum Sema 3 A, KIM-1 were analyzed by univariate analysis. The risk factors affecting the prognosis of DN patients were determined by Logistic regression analysis. The relationship between serum Sema 3 A, KIM-1 and the prognosis of DN patients was evaluated by Pearson correlation analysis.Results By detecting the serum Sema 3 A and KIM-1 of patients with DN of different pathological stages, it was found that the expression levels of serum Sema 3 A and KIM-1 were up-regulated to varying degrees as the disease progressed. Among the 126 DN patients, 54 cases were in the poor prognosis group and 72 cases were in the good prognosis group.The levels of serum Sema 3 A and KIM-1 in the poor prognosis group were higher than those in the good prognosis group, and the differences were significant between the groups(203.24±36.27 vs. 156.39±28.44 ng/ml, 12.54±1.25 vs. 7.63±0.91 ng/ml, all P<0.05).The results of univariate analysis showed that there was no significant difference between the two groups in gender, age, body mass index(BMI), course of disease, past medical history, blood pressure at admission, and the levels of

关 键 词：糖尿病肾病 血清信号素3A 肾损伤分子1 预后 

分 类 号：R587.2[医药卫生—内分泌]