探讨肾功能衰竭患者血清VE-Cad、Ang-2及尿KIM-1表达情况及与病情严重程度的相关性  

To Investigate the Expression of Serum VE-Cad,Ang-2 and Urinary KIM-1 and Its Correlation with Disease Severity in Patients with Renal Failure

作　　者：王星 董玉婷 杨斌 黄艳萍 孙菁菁 WANG Xing;DONG Yu-ting;YANG Bin;HUANG Yan-ping;SUN Jing-jing(Department of Clinical laboratory,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi,710089,China;Tenth outpatient department,986 Hospital of Air Force Military Medical University,Xi'an,Shaanxi,710032,China)

机构地区：[1]西安交通大学第一附属医院检验科,陕西西安710089 [2]空军军医大学九八六医院第十门诊部,陕西西安710032

出　　处：《现代生物医学进展》2022年第20期3868-3872,3901,共6页Progress in Modern Biomedicine

基　　金：陕西省自然科学基础研究计划项目(2017JQ8027)。

摘　　要：目的:探讨肾功能衰竭患者血清血管内皮钙黏蛋白(VE-Cad)、血管生成素2(Ang-2)及尿肾损伤分子1(KIM-1)表达情况及与病情严重程度的相关性。方法:选取我院2018年2月到2021年2月收治的76例慢性肾功能衰竭患者作为研究对象,依照其病情严重程度进行分组,分为肾功能代偿组(n=25),氮质血症组(n=18),肾功能衰竭组(n=21)和尿毒症组(n=12),对比四组患者VE-Cad、Ang-2、KIM-1表达情况,并分析VE-Cad、Ang-2、KIM-1与慢性肾功能衰竭病情严重程度的相关性。对所有患者进行电话随访或复查随访,将76例慢性肾功能衰竭患者依照预后情况分为两个亚组,存活组(n=56)和死亡组(n=20),对比两组患者临床情况和各指标水平,并应用Logistic回归分析分析VE-Cad、Ang-2、KIM-1对慢性肾功能衰竭预后预测价值。结果:四组患者VE-Cad、Ang-2、KIM-1表达水平差异显著,尿毒症组明显高于肾功能衰竭组、氮质血症组和肾功能代偿组(P<0.05);Spearman相关分析结果显示:VE-Cad、Ang-2、KIM-1与慢性肾功能衰竭病情严重程度呈正相关(P<0.05);存活组与死亡组患者性别、年龄、BMI、器官衰竭≥2个、少尿、VE-Cad水平对比无差异(P>0.05),存活组与死亡组患者APACHEⅡ评分、CysC、Ang-2、KIM-1水平对比差异显著(P<0.05);logistic回归分析结果表明,APACHEⅡ评分、CysC、KIM-1为影响慢性肾功能衰竭预后的独立危险因素(P<0.05)。结论:VE-Cad、Ang-2、KIM-1与慢性肾衰竭患者病情严重程度呈正相关,临床可以考虑参考三者水平来评价慢性肾衰竭患者的病情严重程度。而三者中仅有KIM-1与肾功能衰竭患者的预后情况具有一定关系,因此临床可以考虑在APACHEⅡ评分与CysC预测预后的基础上增加KIM-1指标进行判断,进而提升预后预测准确性。Objective:To investigate the expression of serum vascular endothelial cadherin(VE CAD),angiopoietin-2(Ang-2)and urinary renal injury molecule-1(KIM-1)in patients with renal failure and their correlation with the severity of the disease.Methods:76 patients with chronic renal failure treated in our hospital from February 2018 to February 2021 were selected as the research objects.They were divided into renal function compensation group(n=25),azotemia group(n=18),renal failure group(n=21)and uremia group(n=12)according to the severity of their condition.The expressions of ve-cad,Ang-2 and KIM-1 in the four groups were compared and analyzed Correlation between KIM-1 and the severity of chronic renal failure.All patients were followed up by telephone or reexamination.76 patients with chronic renal failure were divided into two subgroups according to the prognosis,survival group(n=56)and death group(n=20).The clinical conditions and index levels of the two groups were compared,and the predictive value of ve-cad,Ang-2 and KIM-1 on the prognosis of chronic renal failure was analyzed by logistic regression analysis.Results:The expression levels of ve-cad,Ang-2 and KIM-1 in uremia group were significantly higher than those in renal failure group,azotemia group and renal function compensation group(P<0.05);Spearman correlation analysis showed that VE CAD,Ang-2 and KIM-1 were positively correlated with the severity of chronic renal failure(P<0.05);There was no significant difference in gender,age,BMI,organ failure≥2,oliguria and ve CAD between the survival group and the death group(P>0.05).There was significant difference in ApacheⅡscore,CysC,Ang-2 and KIM-1 between the survival group and the death group(P<0.05);Logistic regression analysis showed that ApacheⅡscore,CysC and KIM-1 were independent risk factors affecting the prognosis of chronic renal failure(P<0.05).Conclusion:Ve-cad,Ang-2 and KIM-1 are positively correlated with the severity of patients with chronic renal failure.It can be considered to evaluate the se

关 键 词：肾功能衰竭 血管内皮钙黏蛋白 血管生成素2 尿肾损伤分子1 相关性 

分 类 号：R692.5[医药卫生—泌尿科学]