慢性肾脏病患者血清BMP2,BMP7水平表达与左心室肥厚的相关性研究  

Study on Association between Serum BMP2,BMP7 Level and Left Ventricular Hypertrophy among Chronic Kidney Disease Patients

作　　者：贾红红 李红莉[1] 孙丽华 JIA Honghong;LI Hongli;SUN Lihua(Department of Nephrology,Yan’an People’s Hospital,Shaanxi Yan’an 716000,China)

机构地区：[1]延安市人民医院肾内科,陕西延安716000

出　　处：《现代检验医学杂志》2024年第6期179-184,共6页Journal of Modern Laboratory Medicine

基　　金：陕西省自然科学基础研究计划项目(2018JM1056)。

摘　　要：目的探讨慢性肾脏病(chronic kidney disease,CKD)患者血清骨形成蛋白2(bone morphogenetic protein 2,BMP2)、骨形成蛋白7(bone morphogenetic protein 7,BMP7)水平表达与左心室肥厚(left ventricular hypertrophy,LVH)的相关性。方法收集2019年6月~2023年6月延安市人民医院收治的93例CKD患者为CKD组,根据是否并发LVH分为LVH组(n=34)和非LVH组(n=59)。并于同期选取60例健康体检者为对照组。收集各组临床资料并采用酶联免疫吸附法(ELISA)检测血清BMP2和BMP7水平,Spearman秩相关分析血清BMP2和BMP7与CKD分期的关系。Logistic回归分析CKD患者并发LVH的影响因素,绘制ROC曲线评估血清BMP2,BMP7和两指标联合检测对LVH的诊断价值。结果CKD组血清BMP2(106.09±19.34 pg/ml)高于对照组(83.76±15.27 pg/ml),BMP7(15.16±4.92 pg/ml)低于对照组(26.53±5.80 pg/ml),差异具有统计学意义(t=7.559,13.002,均P<0.05)。CKDⅠ期,Ⅱ期,Ⅲ期,Ⅳ期和Ⅴ期患者血清BMP2水平依次升高(90.32±6.04,98.56±6.63,110.32±7.49,121.13±7.82,131.81±7.97 pg/ml),血清BMP7水平依次降低(20.06±2.79,17.01±2.22,13.34±2.18,11.20±2.01,9.35±2.09pg/ml),差异具有统计学意义(F=19.863,11.567,均P<0.05)。血清BMP2与CKD分期呈正相关(r=0.592,P<0.05),血清BMP7与CKD分期呈负相关(r=-0.603,P<0.05)。BMP2是LVH独立危险因素[OR(95%CI):1.640(1.317~2.043),P<0.05];BMP7升高是CKD患者并发LVH的保护因素[OR(95%CI):0.521(0.349~0.779)P<0.05]。血清BMP2,BMP7对LVH均有诊断价值,AUC(95%CI)分别为0.782(0.719~0.832)和0.791(0.726~0.859),二者联合检测的AUC(95%CI)为0.873(0.812~0.930),诊断价值大于单一指标(Z=2.357,2.027,均P<0.05)。结论CKD患者BMP2异常升高,BMP7异常下降,两指标异常表达与CKD病情及LVH相关,早期联合检测可作为诊断LVH的指标。Objective To explore the expression of serum bone morphogenetic protein 2(BMP2),bone morphogenetic protein 7(BMP7)level and its association with left ventricular hypertrophy(LVH)among patients with chronic kidney disease(CKD).Methods A total of 93 CKD patients admitted to Yan’an People’s Hospital from June 2019 to June 2023 were collected as CKD group,divided into LVH group(n=34)and non-LVH group(n=59)according to whether concurrence was combined with LVH.A total of 60 healthy volunteers were selected as control group in the same period.The clinical data were collected and serum BMP2 and BMP7 levels were detected by enzyme-linked immunosorbent assay(ELISA).The association between serum BMP2,BMP7 and CKD stage was analyzed by Spearman’s rank correlation analysis.Logistic regression analyze was performed to analyze the influencing factors of CKD patients with concomitant LVH.ROC curves were plotted to assess the diagnostic value of serum BMP2,BMP7 on LVH.Results Serum BMP2(106.09±19.34 pg/ml)in CKD group was higher than that in control group(83.76±15.27 pg/ml),and serum BMP7(15.16±4.92 pg/ml)in CKD group was lower than that in control group(26.53±5.80 pg/ml),the differences were statistically significant(t=7.559,13.002,all P<0.05).Serum BMP2 was sequentially increased in patients with CKD stages I,II,III,IV and V(90.32±6.04,98.56±6.63,110.32±7.49,121.13±7.82,131.81±7.97 pg/ml),and serum BMP7 was sequentially decreased(20.06±2.79,17.01±2.22,13.34±2.18,11.20±2.01,9.35±2.09 pg/ml),and the differences were statistically significant(F=19.863,11.567,all P<0.05).Serum BMP2 was positively correlated with CKD stage(r=0.592,P<0.05),while serum BMP7 was negatively correlated with CKD stage(r=-0.603,P<0.05).BMP2 was an independent risk factor for LVH in CKD patients[OR(95%CI):1.640(1.317~2.043),P<0.05].BMP7 was a protective factor for LVH in CKD patients[OR(95%CI):0.521(0.349~0.779),P<0.05].Both serum BMP2 and BMP7 had diagnostic value for LVH with AUC(95%CI)of 0.782(0.719~0.832)and 0.791(0.726~0.859),resp

关 键 词：慢性肾脏病 骨形成蛋白2 骨形成蛋白7 左心室肥厚 

分 类 号：R692[医药卫生—泌尿科学] R392.11[医药卫生—外科学]