梗阻性肾病患者的肾脏纤维化与血清EZH2表达的关系  

The relationship between renal fibrosis in patients with obstructive nephropathy and serum EZH2 expression

作　　者：刘亮 刘杨 王景超 张瑜[3] Liu Liang;Liu Yang;Wang Jingchao;Zhang Yu(Department of Urology,Langfang People's Hospital,Langfang 065099,China;Department of Anesthesiology,Langfang People's Hospital,Langfang 065099,China;Department of Urology,Baoding Second Central Hospital,Baoding 072750,China)

机构地区：[1]廊坊市人民医院泌尿外科,廊坊065099 [2]廊坊市人民医院麻醉科,廊坊065099 [3]保定市第二中心医院泌尿外科,保定072750

出　　处：《国际泌尿系统杂志》2024年第3期411-415,共5页International Journal of Urology and Nephrology

基　　金：保定市科技计划项目(2141ZF030)。

摘　　要：目的:探讨Zeste基因增强子同源物2(EZH2)的表达变化与梗阻性肾病患者的肾脏纤维化的关系。方法:回顾性研究2020年1月至2021年5月在廊坊市人民医院收治的95例梗阻性肾病患者的临床资料(梗阻性肾病组),记录患者的估算肾小球滤过率(eGFR)、24 h尿蛋白等资料,根据肾组织纤维化程度将患者分为0级组(26例)、Ⅰ级组(47例)和Ⅱ级组(22例)。同期收集94例体检健康人群作为对照组。采用实时荧光定量PCR(qRT-PCR)法检测血清EZH2 mRNA的相对表达量;采用受试者工作特征(ROC)曲线分析血清EZH2 mRNA水平对梗阻性肾病患者肾脏纤维化的评估价值;采用logistic回归分析梗阻性肾病患者肾脏纤维化程度的影响因素。结果:梗阻性肾病组的血清EZH2 mRNA水平高于对照组(t=29.761,P<0.05)。梗阻性肾病组患者的血清EZH2 mRNA水平与性别、年龄、体质量指数(BMI)均无相关性(均P>0.05),而与估算肾小球滤过率(eGFR)、24 h尿蛋白、间质炎症评分均有相关性(均P<0.05)。eGFR<60 mL·(min·1.73 m^(2))-1、24 h尿蛋白≥3.5 g/24 h、间质炎症评分为1、2分的梗阻性肾病患者的血清EZH2 mRNA水平均高于eGFR≥60 mL·(min·1.73 m^(2))-1、24 h尿蛋白<3.5 g/24 h、间质炎症评分为0分的患者(均P<0.05)。随着肾脏纤维化程度的升高,梗阻性肾病患者的血清EZH2 mRNA水平升高(F=26.473,P<0.05)。血清EZH2 mRNA水平评估梗阻性肾病患者Ⅰ级组患者肾脏纤维化的曲线下面积(AUC)为0.724(95%CI:0.603~0.845),特异度为69.2%,灵敏度为76.6%,截断值为2.42;评估Ⅱ级组患者肾脏纤维化的AUC为0.853(95%CI:0.766~0.940),特异度为68.1%,灵敏度为95.5%,截断值为2.90。EZH2 mRNA是梗阻性肾病患者肾脏纤维化程度发展为Ⅰ级或Ⅱ级的影响因素(均P<0.05)。结论:血清EZH2与梗阻性肾病患者的肾脏纤维化程度呈正相关,可有效评估肾脏纤维化程度。Objective To explore the relationship between the expression changes of enhancer of Zeste homolog 2(EZH2)and renal fibrosis in patients with obstructive nephropathy.MethodssThe clinical data of 95 patients with obstructive nephropathy admitted to Langfang People's Hospital from January 2020 to May 2021(obstructive nephropathy group)were retrospectively studied,and the estimated glomerular filtration rate(eGFR)and 24-hour urinary protein of patients were recorded.According to the degree of renal fibrosis,the patients were divided into grade O group(26 cases),grade I group(47 cases)and grade I group(22 cases).In the same period,94 healthy subjects were collected as control group.The relative expression of EZH2 mRNA in the above serum was detected by real-time quantitative PCR(qRT-PCR)method;receiver operating characteristic(ROC)curve was used to analyze the value of serum EZH2 mRNA level in evaluating renal tissue fibrosis in patients with obstructive nephropathy,and logistic regression was used to analyze the influencing factors of renal tissue fibrosis in patients with obstructive nephropathy.Results The serum EZH2 mRNA level in the obstructive nephropathy group was higher than that in the control group,and the difference was statistically significant(t=29.761,P<0.05).The serum EZH2 mRNA levels in patients with obstructive kidney disease were not correlated with gender,age,and BMI(all P>0.05),but were correlated with eGFR,24-hour urine protein,and interstitial inflammation(all P<0.05).The serum EZH2 mRNA levels in patients with obstructive nephropathy with eGFR<60 mL·(min·1.73 m^(2))-1 were higher than those in patients with eGFR<60 mL·(min·1.73 m^(2))-1.The serum EZH2 mRNA levels in patients with obstructive nephropathy with 24-hour urine protein≥3.5 g/24 h were higher than those in patients with 24-hour urine protein<3.5 g/24 h.The serum EZH2 mRNA levels in patients with obstructive nephropathy with interstitial inflammation scores of 1 and 2 were higher than those in patients with interstitial inflammati

关 键 词：Zeste同源蛋白2增强子 纤维化 肾 梗阻性肾病 

分 类 号：R692[医药卫生—泌尿科学]