特发性膜性肾病患者血清ROCK2、renalase水平及其诊断价值  

Serum ROCK2 and renalase levels in patients with idiopathic membranous nephropathy and their diagnostic value

作　　者：刘慧 钟娇影 陈秀娟 英一铭[2] 刘杰 Liu Hui;Zhong Jiaoying;Chen Xiujuan;Ying Yiming;Liu Jie(Department of Nephrology,Hebei Yiling Hospital,Hebei Province,Shijiazhuang 050000,China)

机构地区：[1]河北以岭医院肾病科,石家庄050000 [2]河北以岭医院检验科,石家庄050000

出　　处：《疑难病杂志》2024年第5期581-584,589,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：河北省中医药管理局科研计划项目(2021190)。

摘　　要：目的探讨Rho相关卷曲螺旋形成蛋白激酶2(ROCK2)、肾胺酶(renalase)在特发性膜性肾病(IMN)患者血清中的表达变化及其对IMN的诊断价值。方法选取2019年1月—2020年11月河北以岭医院肾病科收治IMN患者120例为IMN组,另选取同期医院进行健康体检的志愿者120例为健康对照组。酶联免疫吸附法(ELISA)检测受试者血清ROCK2、renalase水平,Pearson法分析ROCK2、renalase水平与部分临床指标的相关性;采用受试者工作特征(ROC)曲线分析血清ROCK2、renalase及二者联合诊断IMN的价值。结果IMN组ROCK2、renalase水平均显著高于健康对照组(t/P=12.837/<0.001、11.066/<0.001)。Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期IMN患者血清ROCK2逐次升高(F/P=77.154/<0.001),而Ⅰ期、Ⅱ期、Ⅲ期血清renalase水平逐次升高,但Ⅳ期血清renalase水平低于Ⅲ期(F/P=163.042/<0.001)。Alb与血清ROCK2、renalase水平呈负相关(r/P=-0.302/0.009、-0.402/<0.001),PLA2R抗体、BUN、SCr、24 h尿蛋白与血清ROCK2、renalase水平均呈正相关(r/P=0.336/<0.001、0.264/0.011、0.315/0.007、0.320/<0.001,0.359/<0.001、0.284/0.010、0.420/<0.001、0.412/<0.001);ROC曲线显示:血清ROCK2、renalase及二者联合诊断IMN的AUC分别为0.908、0.907、0.965,二者联合优于各自单独预测效能(Z=3.597,3.755,P均<0.001)。结论ROCK2与renalase在IMN患者血清中均高表达,二者联合诊断IMN的价值较高。Objective To investigate the expression changes in Rho-related associated-coil forming protein kinase 2(ROCK2)and renalase in serum of patients with idiopathic membranous nephropathy(IMN)and their diagnostic value for IMN.Methods From January 2019 to November 2020,120 patients with IMN admitted to the Nephrology Department of Yiling Hospital in Hebei Province were selected as the IMN group,and another 120 volunteers who underwent physical examination in the hospital during the same period were selected as healthy control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of serum ROCK2 and renalase in patients with IMN,the correlation between ROCK2 and renalase levels and some clinical indicators was analyzed by Pearson's method;the value of ROCK2,renalase and their combination in the diagnosis of IMN was analyzed by receiver operating characteristic(ROC)curve.Results The levels of ROCK2,renalase in the IMN group were greatly higher than those in healthy control group(t/P=12.837/<0.001,11.066/<0.001).Serum ROCK2 was gradually increased in patients with stageⅠ,Ⅱ,ⅢandⅣIMN(F/P=77.154/<0.001);the level of serum renalase in stageⅠ,Ⅱ,andⅢgradually increased,but the level of serum renalase in stageⅣwere lower than those in stageⅢ(F/P=163.042/<0.001).Alb was negatively correlated with ROCK2 and renalase levels(r/P=-0.302/0.009,-0.402/<0.001).PLA2R antibody,BUN,SCr and 24 h urinary protein were positively correlated with ROCK2 and renalase levels(r=0.336/0.359,0.264/0.284,0.315/0.420,0.320/0.412,0.359/<0.001,0.284/0.010,0.420/<0.001,0.412/<0.001);ROC curve showed that the AUC of ROCK2 for the diagnosis of IMN was 0.908,the AUC of renalase for the diagnosis of IMN was 0.907,the AUC of the two combined for the diagnosis of IMN was 0.965,which was greatly higher than that of the two alone(Z=3.597,3.755,P<0.001).Conclusion Both ROCK2 and renalase are highly expressed in the serum of patients with IMN,and the combination of the two has a high value in the diagnosis of IMN.

关 键 词：特发性膜性肾病 Rho相关卷曲螺旋形成蛋白激酶2 肾胺酶 诊断价值 

分 类 号：R692[医药卫生—泌尿科学] R446.112[医药卫生—外科学]