尿液水通道蛋白2在肾小管功能损伤评价中的价值  

The value of urine aquaporin 2 in the evaluation of renal tubular function injury

作　　者：王盈 张颖 王红燕 Wang Ying;Zhang Ying;Wang Hongyan(Department of Dialysis,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院透析室,北京100038

出　　处：《国际泌尿系统杂志》2022年第3期415-418,共4页International Journal of Urology and Nephrology

摘　　要：目的探讨尿液水通道蛋白2(AQP2)在肾小管功能损伤评价中的价值。方法回顾性分析2020年1月至2021年1月本院收治的86例高血压性肾病患者的临床资料,将其设为肾病组,并根据其是否出现水肿分为水肿组(43例)与非水肿组(43例);同时,选取同期入院进行体检的86例健康者作为研究对象,设为对照组。测定所有研究对象的尿AQP2、血清胱抑素C(Cys-C)、血清肌酐(Scr)、尿β2-微球蛋白(β2-MG)、尿α1-微球蛋白(α1-MG)水平,选取受试者工作特征(ROC)曲线评估尿AQP在肾小管功能损伤诊断中的价值。结果通过百分位数法分析结果显示尿AQP2的参考区间<19.11 ng/mL。肾病组的尿AQP2水平为(25.89±3.84)ng/mL,对照组的尿AQP2水平为(9.41±1.53)ng/mL;与对照组比较,肾病组的尿AQP2水平更高,差异有统计学意义(P<0.001)。水肿组的尿AQP2、β2-MG、α1-MG水平高于非水肿组,差异均有统计学意义(均P<0.01)。ROC曲线分析显示,尿AQP2诊断肾病水肿的曲线下面积(AUC)为0.82,最佳临界值为26.92 ng/mL,灵敏度为71.04%,特异度为81.24%;尿AQP2诊断肾病的AUC为0.92,最佳临界值为18.11 ng/mL,灵敏度为81.42%,特异度为92.62%;尿β2-MG诊断肾病水肿的AUC为0.68,尿α1-MG诊断肾病水肿的AUC为0.79。尿β2-MG、α1-MG、AQP2联合诊断肾病水肿的AUC、灵敏度、特异度依次为0.90、86.83%、87.49%。结论尿AQP2可作为肾小管功能损伤评价中的敏感指标,可提升肾小管功能损伤诊断的准确性。Objective To investigate the value of urine aquaporin 2(AQP2)in the evaluation of renal tubular function injury.Methods A total of 86 patients with hypertensive nephropathy who were admitted to hospital from January 2020 to January 2021 were retrospectively enrolled as the nephropathy group.According to the occurrence of edema,they were divided into edema group(43 cases)and non-edema group(43 cases).At the same time,a total of 86 healthy subjects who were admitted to hospital for physical examination during the same period were selected as the control group.The levels of urine AQP2,serum cystatin C(Cys-C),serum creatinine(Scr),urinaryβ2-microglobulin(β2-MG)and urinaryα1-microglobulin(α1-MG)were determined in all subjects.The value of urinary AQP2 in the diagnosis of renal tubular function injury was evaluated by receiver operating characteristic(ROC)curve.Results Percentile analysis showed that the reference interval of urine AQP2<19.11 ng/mL.The level of urinary AQP2 was(25.89±3.84)ng/mL in nephropathy group and(9.41±1.53)ng/mL in control group.The level of AQP2 in nephropathy group was significantly higher than that in control group(P<0.001).The levels of urine AQP2,urineβ2-MG and urineα1-MG in edema group were higher than those in non-edema group(all P<0.01).ROC curve analysis showed that the area under curve(AUC)of urine AQP2 for the diagnosis of nephrotic edema was 0.82,the optimal critical value was 26.92 ng/mL,the sensitivity was 71.04%,the specificity was 81.24%.The AUC of urinary AQP2 in the diagnosis of nephropathy was 0.92,the optimal critical value was 18.11 ng/mL,the sensitivity was 81.42%,the specificity was 92.62%.The AUC of urinaryβ2-MG in diagnosis of nephrotic edema was 0.68 and that of urinaryα1-MG in diagnosis of nephrotic edema was 0.79.The AUC,sensitivity and specificity of urinaryβ2-MG,α1-MG and AQP2 in the diagnosis of nephrotic edema were 0.90,86.83%and 87.49%,respectively.Conclusions Urine AQP2 can be used as a sensitive index in the evaluation of renal tubular function injur

关 键 词：水通道蛋白质2 尿 高血压性肾病 肾小管 创伤和损伤 

分 类 号：R692[医药卫生—泌尿科学] R544.1[医药卫生—外科学]