血清SDC4、sOX40L水平与糖尿病肾病患者病情严重程度及预后的关系  

The relationship between serum SDC4,sOX40L levels and the severity and prognosis of patients with diabetes nephropathy

作　　者：程海荣[1] 葛少莉 颜妍[1] CHENG Hairong;GE Shaoli;YAN Yan(Department of Renal Medicine,Qingdao Municipal Hospital,Qingdao Shandong 266011,China)

机构地区：[1]青岛市市立医院肾内科,山东青岛266011

出　　处：《中国急救复苏与灾害医学杂志》2024年第4期480-483,487,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：2022年度山东省医药卫生科技发展计划项目(编号:202205020092)。

摘　　要：目的分析血清SDC4、sOX40L水平与糖尿病肾病(DN)患者病情严重程度及预后的关系。方法以青岛市市立医院2019年5月—2021年11月收治的172例糖尿病患者为研究对象,其中DN患者84例(DN组),无肾病患者88例(单纯糖尿病组),另选取同期在我院体检的80例健康人群为对照组。比较三组血清SDC4、sOX40L水平;分析血清SDC4、sOX40L水平与DN患者临床指标的关系;Spearman相关性分析DN患者血清SDC4、sOX40L水平与肾脏病理损伤程度的关系;根据是否出现死亡或发展为终末期肾病(ESRD)将DN患者分为预后良好组和预后不良组,Logistic回归分析DN患者预后的影响因素。结果与对照组相比,糖尿病患者血清SDC4、sOX40L水平均显著升高(P<0.05),且DN组患者血清SDC4、sOX40L水平显著高于单纯糖尿病组(P<0.05);DN组患者血清SDC4、sOX40L水平与糖尿病病程、空腹血糖(FBG)、24 h尿蛋白定量、糖化血红蛋白(HbA_(1)c)、肾小球滤过率(eGFR)、血肌酐均相关(P<0.05),而与DN患者年龄、性别、BMI无关(P>0.05);DN组患者血清SDC4、sOX40L水平与肾小球分级、小管萎缩(IFTA)评分、间质炎症均相关(P<0.05),且随着肾脏损伤程度的加深,血清SDC4、sOX40L水平逐渐升高(P<0.05);Spearman相关性分析表明,DN组患者血清SDC4、sOX40L水平与肾小球分级、IFTA评分、间质炎症均呈显著正相关(P<0.05);预后不良组患者血清SDC4、sOX40L水平均显著高于预后良好组患者(P<0.05);Logistic回归分析结果表明,糖尿病病程、FBG、24 h尿蛋白定量、HbA1c、eGFR、血肌酐、SDC4、sOX40L是影响DN患者预后不良的独立危险因素(P<0.05)。结论DN患者血清SDC4、sOX40L表达水平与肾脏损伤程度及预后均具有相关性,血清SDC4、sOX40L表达水平越高,DN患者病情越严重,预后越差。Objective To analyze the relationship between serum SDC4,sOX40L levels and the severity and prognosis of patients with diabetes nephropathy(DN).Methods A total of 172 patients with diabetes admitted to our hospital from May 2019 to November 2021 were regarded as the study subjects,including 84 patients with DN(DN group),88 patients without kidney disease(simple diabetes group),and 80 healthy people who were examined in our hospital were included as the control group.The levels of serum SDC4 and sOX40L in the three groups were compared.The relationship between serum SDC4,sOX40L and related clinical indicators in DN patients was analyzed.Spearman correlation analysis was applied to evaluate the correlation between the levels of serum SDC4,sOX40L and the degree of renal pathological damage in DN patients.DN patients were grouped into good prognosis group and bad prognosis group according to whether they died or developed into end-stage renal disease(ESRD),and Logistic regression was applied to analyze the prognostic factors of DN patients.Results Compared with the control group,the serum SDC4 and sOX40L level of diabetic patients were significantly increased(P<0.05),and the serum SDC4,sOX40L level of DN group was significantly higher than that of simple diabetic group(P<0.05).The levels of serum SDC4 and sOX40L in patients with DN were correlated with the course of diabetes,fasting blood glucose(FBG),24-hour urinary protein quantitation,HbA1c,glomerular filtration rate(eGFR),and serum creatinine(P<0.05);the levels of serum SDC4 and sOX40L in DN group were correlated with glomerular grade(P<0.05),IFTA score and interstitial inflammation,and the levels of serum SDC4 and sOX40L increased gradually with the degree of renal injury(P<0.05);Spearman correlation analysis showed that the levels of serum SDC4 and sOX40L in DN group were obviously positively correlated with glomerular grade,IFTA score and interstitial inflammation(P<0.05);the levels of serum SDC4 and sOX40L in patients with poor prognosis were obviously higher

关 键 词：糖尿病肾病 SDC4 SOX40L 预后 

分 类 号：R587.2[医药卫生—内分泌]