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| 人附睾蛋白4在女性慢性肾脏病中的表达及临床价值 |
| Expression and clinical value of human epididymal protein 4 in female chronic kidney disease |
| 投稿时间：2021-12-25 |
| DOI：10.3969/j.issn.1000-0399.2022.06.001 |
| 中文关键词: 女性,慢性肾脏病 分期 人附睾蛋白4 |
| 英文关键词: Female, Chronic kidney disease Staging Human epididymal protein 4 |
| 基金项目:安徽省自然科学基金面上项目(项目编号:2008085MH244) |
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| 中文摘要: |
| 目的 分析人附睾蛋白4(HE4)在女性慢性肾脏病(CKD)患者中的表达及其临床价值。方法 选取2020年6月至2021年12月安徽医科大学第二附属医院收治的112例非肿瘤CKD女性患者和同时期60例健康对照为研究对象,分别纳入CKD患者组和健康对照组。采用电化学发光法检测血清HE4,免疫比浊法检测血清肌酐(Cr)、尿素氮(BUN)、尿酸(UA),运用简化的肾脏病膳食改良实验(MDRD)公式估算肾小球滤过率(eGFR),构建受试者工作特征(ROC)曲线分析HE4在诊断CKD中的价值,比较不同CKD分期患者中HE4、Cr、BUN、UA表达水平及eGFR的差异,Spearman秩相关分析HE4与Cr、BUN、UA及eGFR的相关性。结果 CKD患者组血清HE4水平高于健康对照组[570.00(260.75,944.75)pmol/L比49.12(43.06, 59.84)pmol/L],差异有统计学意义(P<0.001)。ROC曲线分析结果显示,HE4诊断CKD的曲线下面积(AUC)为0.962(95%CI:0.922~0.985),灵敏度为94.6%,特异度为81.7%,最佳截断值为79.9 pmol/L;HE4在CKD不同分期组间比较,差异有统计学意义(P<0.05),其中终末期CKD患者透析组HE4水平高于非透析组[1 081.50(911.75,1 284.25)pmol/L比617.50(516.50,782.00)pmol/L],差异有统计学意义。CKD患者血清HE4表达水平与BUN和Cr均呈正相关(r=0.696、0.875,P均<0.001),与eGFR呈负相关(r=-0.873,P<0.001)。结论 血清人附睾蛋白4在女性CKD患者中的表达水平明显升高,对CKD具有较高的诊断价值,同时与CKD病程进展密切相关。 |
| 英文摘要: |
| Objective To analyze the expression and clinical value of human epididymal protein 4 (HE4) in female patients with chronic kidney disease (CKD).Methods A total of 112 non tumor female CKD patients treated in the Second Affiliated Hospital of Anhui Medical University from June 2020 to December 2021 and 60 healthy controls who came to the hospital at the same time were selected as the research objects, which were included in the CKD patient group and the healthy control group respectively.Serum HE4 was detected by electro-chemiluminescence, creatinine (Cr), blood urea nitrogen (BUN) and uric acid (UA) were detected by immunoturbidimetry. Estimated Glomerular filtration rate (eGFR) was calculated by simplified and Modification of Diet in Renal Diseases(MDRD) formula. The value of HE4 in the diagnosis of CKD was analyzed by constructing the receiver operating characteristic (ROC) curve. The expression levels of HE4, Cr, BUN, UA and eGFR in patients with different stages of CKD were compared. The correlation between HE4 and Cr, BUN, UA and eGFR was analyzed by Spearman rank correlation.Results The level of serum HE4 in CKD patient group was significantly higher than that in healthy controls [570.00(260.75, 944.75)pmol/L vs 49.12 (43.06, 59.84) pmol/L,and the difference was statistically significant (P<0.001). ROC curve analysis showed that the area under the curve (AUC) of HE4 in the diagnosis of CKD was 0.962(95%CI: 0.922~0.985), the sensitivity was 94.6%, the specificity was 81.7% and the optimal cut off value was 79.9 pmol/L;there was significant difference in the expression of HE4 between different stages of CKD (P<0.05). The level of HE4 in dialysis group was significantly higher than that in non dialysis group [1 081.50 (911.75, 1284.25) pmol/L vs. 617.50 (516.50, 782.00) pmol/L], and the difference was statistically significant. The level of serum HE4 expression in CKD patients was positively correlated with BUN and Cr(r=0.696,0.875,P<0.001), while negatively correlated with eGFR (r=-0.873, P< 0.001).Conclusions The expression level of serum human epididymal protein 4 in female patients with CKD significantly increases, which has high diagnostic value for CKD and is closely related to the progression of CKD. |
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