原发性肾病综合征患者血清黏附分子、胰岛素样生长因子-1水平与急性肾损伤的相关性  

Changes of Serum Vascular Cell Adhesion Molecule-1,Insulin-Like Growth Factor-1 Levels and Acute Kidney Injury in Patients with Idiopathic Nephrotic Syndrome

作　　者：杜志雷 薛现军[2] 郑玉南 DU Zhilei;XUE Xianjun;ZHENG Yunan(Department of Nephrology,Qingfeng First Hospital,Puyang 457300,China;Department of Nephrology,Puyang Oilfield General Hospital,Puyang 457300,China)

机构地区：[1]清丰第一医院肾病内科,河南濮阳457300 [2]濮阳市油田总医院肾病内科,河南濮阳457300

出　　处：《河南医学研究》2022年第19期3573-3576,共4页Henan Medical Research

摘　　要：目的 探讨原发性肾病综合征(INS)患者血清黏附分子(VCAM-1)、胰岛素样生长因子-1(IGF-1)水平变化及其与急性肾损伤(AKI)的相关性。方法 选取2019年2月至2021年3月清丰第一医院收治的69例INS患者,根据是否合并AKI分为INS组(未合并AKI,42例)和AKI组(合并AKI,27例),同时选择同期健康体检者33例作为正常对照组,对比3组血肌酐(SCr)、尿素氮(UN)、VCAM-1和IGF-1表达情况,分析其与AKI的联系。结果 3组VCAM-1、IGF-1水平比较,差异有统计学意义(P<0.05)。3组UN和SCr水平比较差异有统计学意义(P<0.05)。VCAM-1与UN、SCr水平呈正相关(r=0.357,r=0.396,P<0.05),IGF-1与UN、SCr呈负相关(r=-0.403,r=-0.418,P<0.05)。根据受试者工作特征(ROC)曲线,当VCAM-1为1.43 mg·L^(-1),IGF-1为96.91μg·L^(-1)时可获得ROC曲线下最大面积,表明AKI与VCAM-1、IGF-1A密切相关,VCAM-1的敏感度为79.70%,特异度为81.80%,IGF-1的敏感度为84.10%,特异度为90.90%。结论 检测血清VCAM-1和IGF-1水平能够早期诊断INS患者是否合并AKI。Objective To investigate the changes of vascular cell adhesion molecule-1(VCAM-1) and insulin-like growth factor-1(IGF-1) levels in patients with idiopathic nephrotic syndrome(INS) and their correlation with acute kidney injury(AKI).Methods Sixty-nine INS patients included in Qingfeng First Hospital from February 2019 to March 2021 were selected and divided into INS group(without AKI,42 cases) and an AKI group(with AKI,27 cases) according to whether they had AKI or not.Another 33 healthy subjects during the same period were selected as the normal control group.The serum VCAM-1 and IGF-1 levels in the three groups were compared,and their relationship with AKI was analyzed.Results The differences of VCAM-1 and IGF-1 among the three groups had statistical significance(P<0.05).The differences of UN and SCr among the three groups were statistically significant(P<0.05).VCAM-1 was positively correlated with UN and SCr(r=0.357,r=0.396,P<0.05),IGF-1 was negatively correlated with UN and SCr(r=-0.403,r=-0.418,P<0.05).According to the receiver operating characteristic(ROC) curve,the maximum area under ROC curve could be obtained when VCAM-1 was 1.43 mg·L^(-1) and IGF-1 was 96.91 μg·L^(-1),indicating that AKI was closely related to VCAM-1 and IGF-1,the VCAM-1 sensitivity was 79.70% and specificity was 81.80%,the IGF-1 sensitivity was 84.10% and specificity was 90.90%.Conclusion The detection of serum VCAM-1 and IGF-1 levels can early diagnose whether INS patients are complicated with AKI.

关 键 词：肾病综合征 血管细胞黏附分子 胰岛素样生长因子-1 急性肾损伤 

分 类 号：R692.5[医药卫生—泌尿科学]