ISSN 1006-298X      CN 32-1425/R

导航

肾脏病与透析肾移植杂志 ›› 2016, Vol. 25 ›› Issue (2): 128-133.

• 论文 • 上一篇    下一篇

慢性肾脏病患者血清人附睾蛋白4与疾病进展的关系

  

  • 出版日期:2016-04-28 发布日期:2016-05-04

Significance of serum human epididymis protein 4 levels in patients with chronic kidney disease

  • Online:2016-04-28 Published:2016-05-04

摘要:

摘 要 目的:探讨人附睾蛋白4(HE4)在慢性肾脏病患者(CKD)血清中的表达水平及其与CKD进展的关系。方法:本研究前瞻性收集了112例CKD患者的临床资料及血清标本,用酶联免疫吸附(ELISA)法对血清HE4水平进行检测。结果:CKD组血清HE4为(82.42±46.29)pmol/L,明显高于正常对照组(29.85±15.18)pmol/L,P<0.001。CKD各分期之间血清HE4的表达水平有显著差异(P<0.01),但在各病因之间血清HE4水平差异无统计学意义(P>0.05)。HE4表达水平与肾小球滤过率(eGFR)呈负相关(r=-0.712,P<0.001),与患者年龄、肌酐、尿素氮、胱抑素C及肾间质纤维化的比例呈正相关(r=0.377,r=0.476,r=0.561,r=0.612,r=0.487,P<0.01)。生存曲线分析表明循环中较高水平的HE4与较低的肾脏存活率相关。多因素分析可以得知,血清HE4水平为CKD独立的预后因子(HR=1.032,P=0.001)。结论:血清中高表达的HE4与CKD患者的肾脏不良预后相关,表明HE4可能是CKD进展的一个血清生物学指标。

关键词: 慢性肾脏病, 人附睾蛋白4, 血清, 预后

Abstract:

ABSTRACT
Objective:To investigate the expression levels of HE4 in the serum of CKD patients and the relationship to CKD progression. Methodology:We prospectively collected the clinical data and serum samples of 112 CKD patients and serum HE4 concentration of the participants were tested using ELISA. Results: CKD patients had significantly higher serum HE4 concentration than the health controls (82.42±46.29 versus 29.85±15.18, P<0.001). Serum HE4 levels were significantly different among CKD stages (P<0.01), but were not significantly different among various pathological types of CKD(P>0.05). HE4 levels in the serum were inversely correlated with estimated glomerular filtration rates (eGFRs) (r=-0.712, P<0.001). In addition, positive correlations were found between serum HE4 levels and age, serum creatinine, blood urea nitrogen, cystatin C and the proportions of tubulointerstitial fibrosis(r=0.377, r=0.476, r=0.561, r=0.612, r=0.487, P<0.01; respectively). Kaplan–Meier survival curves showed that higher serum HE4 level was associated with shorter renal survival duration. Cox multivariate analyses further demonstrated that serum HE4 concentration was an independent prognostic factor for CKD patients (HR = 1.032, P= 0.001). Conclusion: Our study showed that high circulating HE4 levels were associated with adverse kidney disease outcome, suggesting that HE4 is a novel biomarker for CKD progression.

Key words: Chronic kidney diseases, Human epididymis protein 4, Serum, Outcome