血清白蛋白、γ-谷氨酰转移酶水平与成人特发性膜性肾病发生高尿酸血症的关系  

Relationship between serum albumin γ-glutamyltransferase level and hyperuricemia in adult idiopathic membranous nephropathy

作　　者：郭珊珊[1] 许杨 郭莉[1] 李建东[1] 郑喜洁 陈航[1] Guo Shanshan;Xu Yang;Guo Li;Li Jiandong;Zheng Xijie;Chen Hang(Department of Nephrology,Affiliated Hospital of Hebei University,Hebei Province,Baoding 071000,China)

机构地区：[1]河北大学附属医院肾内科,河北省保定071000

出　　处：《疑难病杂志》2023年第3期289-293,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：保定市科技局项目(2041ZF316)。

摘　　要：目的 分析血清白蛋白、γ-谷氨酰转移酶(γ-GTP)水平与成人特发性膜性肾病(IMN)发生高尿酸血症(HUA)的关系。方法 选择2020年1月—2021年12月河北大学附属医院肾内科收治的IMN患者136例,根据是否患有HUA将患者分为HUA组36例和非HUA组100例。收集临床相关资料,检测血清白蛋白、γ-GTP水平,Pearson法分析血清白蛋白、γ-GTP水平与尿酸(UA)水平的相关性,多因素Logistic回归分析IMN患者发生HUA的危险因素,受试者工作特征曲线(ROC)分析血清白蛋白、γ-GTP诊断IMN患者发生HUA的价值。结果 HUA组血清白蛋白低于非HUA组,血清γ-GTP水平高于非HUA组(t/P=6.591/<0.001、10.147/<0.001)。Pearson相关分析显示,HUA组血清白蛋白与UA水平呈负相关(r/P=-0.737/<0.001),γ-GTP水平与UA水平呈正相关(r/P=0.774/<0.001)。多因素Logistic回归分析显示,血肌酐高、高血压、γ-GTP高是IMN患者发生HUA的危险因素[OR(95%CI)=2.064(1.136~3.754)、1.514(1.087~2.109)、1.349(1.102~1.650)],血清白蛋白高是其保护因素[OR(95%CI)=0.674(0.481~0.944)]。ROC曲线分析显示,血清白蛋白、γ-GTP及二者联合诊断IMN患者发生HUA的曲线下面积为0.785、0.768、0.908,二者联合诊断效能高于单项指标(Z/P=2.814/0.012、3.715/<0.001)。结论 IMN合并HUA患者血清白蛋白水平降低,γ-GTP水平升高,且与尿酸水平增高及HUA发生有关。Objective To analyze serum albumin γ-Glutamyltransferase(γ-GTP). The relationship between GTP level and hyperuricemia(HUA) in adult idiopathic membranous nephropathy(IMN). Methods One hundred and thirty-six patients with IMN admitted to the Department of Nephrology of the Affiliated Hospital of Hebei University from January 2020 to December 2021 were selected, and the patients were divided into 36 patients in the HUA group and 100 patients in the non-HUA group according to whether they had HUA. Collect relevant clinical data and detect serum albumin γ-GTP level, Pearson method for analysis of serum albumin γ-Correlation between GTP level and uric acid(UA) level, multi-factor logistic regression analysis of risk factors for the occurrence of UA in IMN patients, and the analysis of serum albumin γ-The value of GTP in diagnosis of HUA in patients with IMN. Results Serum albumin in HUA group is lower than that in non-HUA group γ-The level of GTP was higher than that of non-HUA group(t/P=6.591/<0.001,10.147/<0.001). Pearson correlation analysis showed that there was a negative correlation between serum albumin and UA level in HUA group(r/P=-0.737/<0.001), γ-GTP level was positively correlated with UA level(r/P=0.774/<0.001). Multivariate logistic regression analysis showed that high serum creatinine, hypertension γ-High GTP is a risk factor for the occurrence of UA in IMN patients [OR(95% CI)=2.064(1.136-3.754), 1.514(1.087-2.109), 1.349(1.102-1.650)], and high serum albumin is a protective factor [OR(95% CI)=0.674(0.481-0.944)]. ROC curve analysis showed that serum albumin γ-The area under the curve of HUA in IMN patients diagnosed by GTP and their combination was 0.785, 0.768 and 0.908, and their combined diagnostic efficacy was higher than that of single index(Z/P=2.814/0.012, 3.715/<0.001). Conclusion The serum albumin level of patients with IMN and HUA decreased, γ-The level of GTP increased, which was related to the increase of uric acid level and the occurrence of HUA.

关 键 词：特发性膜性肾病 高尿酸血症 白蛋白 Γ-谷氨酰转移酶 

分 类 号：R692[医药卫生—泌尿科学]