血清人附睾蛋白4对慢性肾脏疾病的临床诊断价值

李秀义; 齐向明; 夏圆圆; 罗锐; 韩树葳; 余小琴

doi:10.16766/j.cnki.issn.1674-4152.002455

血清人附睾蛋白4对慢性肾脏疾病的临床诊断价值

doi: 10.16766/j.cnki.issn.1674-4152.002455

1.
合肥市第一人民医院安徽医科大学第三附属医院检验科，安徽合肥 230061
2.
安徽医科大学第二附属医院肾内科，安徽合肥 230601

基金项目:

安徽省自然科学基金项目 1908085MH245

详细信息

通讯作者:
余小琴，E-mail：xiaoqin6828@126.com

中图分类号: R692
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- 被引次数: 0
出版历程
- 收稿日期: 2021-11-11
- 网络出版日期: 2022-09-05

Clinical value of serum human epididymal protein 4 in the diagnosis of chronic kidney disease

1.
Department of Clinical Laboratory, the First People's Hospital of Hefei (the Third Affiliated Hospital of Anhui Medical University), Hefei, Anhui 230061, China

摘要

摘要: 目的探讨血清人附睾蛋白4(HE4)对慢性肾脏疾病(CKD)及不同分期的临床诊断价值。方法选取2019年2月—2020年9月合肥市第一人民医院肾病科收治的117例CKD患者作为观察组，同期年龄相当的健康体检者78例设为对照组。检测2组受试者血清HE4、尿素氮(BUN)、肌酐(SCr)、胱抑素C(CysC)和视黄醇结合蛋白(RBP)表达水平，比较其2组之间差异，观察其相关性及对CKD临床诊断价值。结果 CKD组患者血清HE4、BUN、SCr、CysC和RBP表达水平明显高于对照组(均P＜0.01)。随着患者CKD分期的上升，CKD各期与对照组比较，BUN和SCr和RBP的早期分组与对照组相比较差异无统计学意义(均P＞0.05), 其余各分期组与对照组相比较差异均有统计学意义(均P＜0.01)；CKD 1~5各分期组间比较发现，HE4、CysC和RBP各组间相比较差异均有统计学意义(均P＜0.05)，BUN和SCr各组间相比较，CKD 1与CKD 2之间差异无统计学意义(均P＞0.05)，CKD 3~CKD 5组间以及与CKD 1~CKD 2比较，差异均有统计学意义(均P＜0.01)。血清HE4的表达水平与eGFR呈负相关关系；与BUN、SCr、CysC及RBP呈正相关关系。ROC分析显示HE4的曲线下面积为(AUC=0.978)明显优于Bun(AUC=0.956)、SCr(AUC=0.973)、CysC(AUC=0.992)和RBP(AUC=0.910)。结论血清HE4水平变化与CKD的发生发展有关，对CKD的分期有一定的临床意义，有望为CKD进展及预后预测提供新的血清生物学诊断标记物。
- 慢性肾脏疾病 /
- 人附睾蛋白4 /
- 肾功能 /
- 诊断价值
Abstract: Objective To investigate the clinical diagnostic value of serum human epididymal protein 4 (HE4) in chronic kidney disease (CKD) and different stages. Methods A total of 117 patients with CKD admitted to the Department of Nephrology of Hefei First People's Hospital from February 2019 to September 2020 were selected as the observation group, and 78 healthy patients with the same age during the same period were selected as the control group. The expression levels of serum HE4, urea nitrogen (BUN), creatinine (SCr), cystatin C (CysC) and retinol-binding protein (RBP) in the subjects of the two groups were detected to observe the correlation and clinical diagnostic value of CKD. Results The expression levels of serum HE4, BUN, SCr, CysC and RBP in the CKD group were significantly higher than those in the control group (all P < 0.01). As the CKD stage of the patients increased, no significant difference in the early grouping of BUN, SCr and RBP was found compared with the control group in each stage of CKD and the control group (all P>0.05). The other staging groups were compared with the control group, and the differences were statistically significant (all P < 0.01). The comparison amongst the CKD 1 - 5 staging groups revealed that the HE4, CysC and RBP groups had statistically significant differences (all P < 0.05), and BUN and SCr were significantly different (all P < 0.05). Compared between groups, there was no significant difference between CKD 1 and CKD 2 (all P>0.05), and significant differences were noted between the CKD 3 and CKD 5 groups and compared with CKD 1 to CKD 2 (all P < 0.01). The expression level of serum HE4 was negatively correlated with eGFR but positively correlated with BUN, SCr, CysC and RBP. ROC analysis showed that the area under the curve of HE4 (AUC=0.978) was significantly better than that of Bun (AUC=0.956), SCr (AUC=0.973), CysC (AUC=0.992) and RBP (AUC=0.910). Conclusion The serum HE4 level is related to the occurrence and development of CKD, and it has certain clinical significance for the staging of CKD. Serum HE4 is expected to function as a new serum biological diagnostic marker for the progression and prognosis of CKD.
- Chronic kidney disease /
- Human epididymal protein 4 /
- Renal function /
- Diagnostic value

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图 1 血清HE4、BUN、SCr、CysC和RBP表达水平对CKD的ROC曲线

Figure 1. ROC curve of serum HE4, BUN, SCr, CysC and RBP expression levels on CKD

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表 1 2组血清HE4、BUN、SCr、CysC和RBP表达水平比较(x±s)

Table 1. The expression levels of HE4, BUN, SCr, CysC and RBP in serum were compared between the two groups(x±s)

组别	例数	HE4(pmol/L)	BUN(pmol/L)	SCr(μmol/L)	CysC(mg/L)	RBP(mg/L)
对照组	78	58.93±8.69	4.73±0.69	55.03±5.49	0.71±0.09	57.83±12.36
CKD组	117	906.82±545.12	15.78±8.01	380.96±233.37	3.45±1.45	110.98±42.93
t值		16.821	14.840	15.101	20.381	12.630
P值		< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

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表 2 CKD不同分期组与对照组血清HE4、BUN、SCr、CysC和RBP表达水平比较(x±s)

Table 2. The expression levels of serum HE4, BUN, SCr, CysC and RBP were compared between different stages of CKD and the control group(x±s)

组别	例数	HE4(pmol/L)	BUN(pmol/L)	SCr(μmol/L)	CysC(mg/L)	RBP(mg/L)
对照组	78	58.93±8.69	4.73±0.69	55.03±5.49	0.71±0.09	57.83±12.36
CKD 1组	15	85.75±22.81	4.90±0.65^a	55.12±6.98^a	0.88±0.14	62.92±8.04^a
CKD 2组	20	260.00±128.00	5.05±0.62^ab	58.6±10.95^ab	1.28±0.10	70.27±4.54
CKD 3组	23	254.58±66.38	9.16±2.28	130.52±14.74	1.91±0.21	81.50±9.50
CKD 4组	30	457.22±177.51	14.18±3.69	199.92±37.91	2.83±0.35	97.14±13.97
CKD 5组	29	1 189.56±453.97	20.68±6.75	459.78±155.00	5.19±1.72	123.72±12.14
F值		4.528	9.127	8.274	13.998	12.761
P值		< 0.001	0.017	0.021	< 0.001	< 0.001
注：对照组比较，^aP＞0.05；与CKD 1组比较，^bP＞0.05；其余同项目下组间两两比较差异均有统计学意义(均P＜0.05)。

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