尿KIM-1及Netrin-1水平与慢性乙肝患者药源性肾损伤的相关性分析  

Relationship between urinary KIM-1,Netrin-1 and drug-induced renal dysfunction in chronic hepatitis B patients

作　　者：贾元华 张婷[2] 马竹生 丁延超 胡昕 JIA Yuanhua;ZHANG Ting;MA Zhusheng;DING Yanchao;HU Xin(Department of Medical Examination,Shanghai Yangsi Hospital,Shanghai 200126,China;Department of Medical Examination,Shanghai Changzheng Hospital,Shanghai 200003)

机构地区：[1]上海杨思医院检验科,上海200126 [2]上海长征医院检验科,上海200003

出　　处：《徐州医科大学学报》2022年第6期451-454,共4页Journal of Xuzhou Medical University

基　　金：上海市卫生系统优秀青年医学人才培养项目(PWRq2018-33)。

摘　　要：目的通过检测慢性乙型肝炎(慢性乙肝)患者药物治疗前后尿液中肾损伤分子-1(KIM-1)及神经导向因子-1(Netrin-1)的浓度,观察KIM-1及Netrin-1与慢性乙肝患者药源性肾损伤的相关性。方法选取95例慢性乙肝患者,收集患者治疗前及治疗后12、24、36、48周时的空腹血及晨尿。通过酶联免疫吸附实验(ELISA)检测患者治疗前后尿液中KIM-1、Netrin-1表达量,利用常规生化试剂检测血清中HBV-DNA含量,丙氨酸氨基转移酶(ALT)、肌酐(Cr)水平并估算肾小球滤过率(eGFR)。结果慢性乙肝患者药物治疗后,患者体内的HBV-DNA含量、ALT水平显著降低。通过ELISA检测发现,慢性乙肝患者药物治疗后,尿液中KIM-1、Netrin-1含量较治疗前增高(P<0.05或P<0.01)。且尿KIM-1、Netrin-1均与Cr变化呈正相关,与eGFR变化呈负相关。结论尿KIM-1及Netrin-1水平与慢性乙肝患者药源性肾损伤有关,对肾损伤程度有一定的预测价值。Objective To detect the concentrations of kidney injury molecule 1(KIM-1)and Netrin-1 in the urine of chronic hepatitis B patients before and after drug treatment and observe the relationship between KIM-1,Netrin-1 and drug-induced renal dysfunction in chronic hepatitis B patients.Methods A total of 95 patients with chronic hepatitis B were selected.Their fasting blood and morning urine were collected before and 12,24,36,and 48 weeks after treatment.The expression of KIM-1 and Netrin-1 in the urine before and after treatment was detected by enzyme-linked immunosorbent assay(ELISA).The content of serum HBV-DNA,ALT,creatinine(Cr)and estimated glomerular filtration rate(eGFR)were measured by conventional biochemical reagents.Results After drug treatment,HBV-DNA content and ALT were significantly reduced in chronic hepatitis B patients.Through ELISA assay,the contents of KIM-1 and Netrin-1 in the urine of chronic hepatitis B patients after drug treatment were higher than those before treatment(P<0.05 or P<0.01).Meanwhile,both urinary KIM-1 and Netrin-1 were positively correlated with the changes in Cr and negatively correlated with the changes in eGFR.Conclusions The levels of urinary KIM-1 and Netrin-1 are significantly associated with drug-induced renal dysfunction in chronic hepatitis B,which are useful to predict renal injury.

关 键 词：肾损伤分子-1 神经导向因子-1 慢性乙型肝炎 药源性肾损伤 

分 类 号：R692[医药卫生—泌尿科学]