慢性肾脏病不同阶段患者血清ProGRP、NSE、CYFRA21-1水平的变化  

Changes of serum ProGRP,NSE and CYFRA21-1 levels among the patients with different stages of chronic kidney disease

作　　者：戴健敏[1] 陈诺 魏坚[3] DAI Jianmin;CHEN Nuo;WEI Jian(Faculty of Laboratory Medicine,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Shanghai University of Medicine and Health Sciences,Shanghai 201318,China;Department of Clinical Laboratory,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院检验系,上海200025 [2]上海健康医学院,上海201318 [3]上海交通大学医学院附属瑞金医院检验科,上海200025

出　　处：《检验医学》2022年第9期811-814,共4页Laboratory Medicine

摘　　要：目的 分析慢性肾脏病(CKD)不同阶段患者血清胃泌素释放肽前体(ProGRP)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA21-1)水平的变化。方法 选取肾功能受损患者196例,根据肾功能衰竭分期标准分为肾功能代偿期组[59例,肌酐(Cr)为133~177μmol/mL]、肾功能失代偿期组(49例,Cr为178~442μmol/mL)、肾功能衰竭期组(46例,Cr为443~706μmol/mL)、尿毒症期组(42例,Cr≥707μmol/mL)。以体检健康者100名作为正常对照组。检测所有对象血清ProGRP、NSE、CYFRA21-1和Cr水平。结果 正常对照组、肾功能代偿期组、肾功能失代偿期组、肾功能衰竭期组、尿毒症期组血清ProGRP水平均依次升高(P<0.01)。肾功能失代偿期组、肾功能衰竭期组、尿毒症期组之间血清NSE水平差异均有统计学意义(P<0.05),且均高于肾功能代偿期组和正常对照组(P<0.05);肾功能代偿期组与正常对照组之间血清NSE水平差异无统计学意义(P>0.05)。肾功能损伤各组血清CYFRA21-1水平均高于正常对照组(P<0.05),肾功能失代偿期组、肾功能衰竭期组、尿毒症期组之间差异均无统计学意义(P>0.05)。3项指标中,血清ProGRP水平升高幅度最大。结论 肾功能损伤可导致ProGRP、NSE、CYFRA21-1水平呈不同程度的升高。临床应关注肾功能对相关肿瘤标志物的影响。Objective To investigate the changes of serum gastrin-releasing peptide precursor(ProGRP),neuron-specific enolase(NSE) and cytokeratin 19 fragment(CYFRA21-1) among the patients with different stages of chronic kidney disease(CKD). Methods Totally,196 patients with impaired renal function were classified into 4 groups according to the criteria of renal function failure stages,including renal function compensation group [59 cases,creatinine(Cr) 133-177 μmol/mL],renal function decompensation group(49 cases,Cr 178-442μmol/mL),renal failure group(46 cases,Cr 443-706 μmol/mL) and uremia group(42 cases,Cr≥707 μmol/mL). Totally,100 healthy subjects were enrolled as healthy control group. Serum ProGRP,NSE,CYFRA21-1and Cr levels were determined. Results Serum ProGRP levels in healthy control group,renal function compensation group,renal function decompensation group,renal failure group and uremia group were all increased in turn(P<0.01). Serum NSE levels in renal function decompensation group,renal failure group and uremia group were all statistically significant(P<0.05),and all of them were higher than those in renal function compensation group and healthy control group(P<0.05),but there was no statistical significance between renal function compensation group and healthy control group(P>0.05). Serum CYFRA21-1 levels in all the groups with impaired renal function were higher than those in healthy control group(P<0.05),but there was no statistical significance among renal function decompensation group,renal failure group and uremia group(P>0.05). Among the 3 indexes,the level of serum ProGRP was increased the most significantly. Conclusions Renal function injury can lead to the increasing of ProGRP,NSE and CYFRA21-1 in different degrees. Attention should be paid to the effect of renal function on tumor markers in clinical practice.

关 键 词：胃泌素释放肽前体 神经元特异性烯醇化酶 细胞角蛋白19片段 肾功能损伤 慢性肾功能衰竭 

分 类 号：R446.1[医药卫生—诊断学]