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血清肿瘤特异性生长因子水平在慢性肾脏病患者肾功能损害严重程度评估中的应用
作者:罗兵1  孙敏捷2  冯梅1  陈琼1  霍星星3  徐伟明1  李涛4 
单位:1. 安徽省第二人民医院 检验科, 安徽 合肥 230041;
2. 安徽省第二人民医院 手术室, 安徽 合肥 230041;
3. 安徽省中医院 科研中心, 安徽 合肥 230020;
4. 安徽医科大学第一附属医院 检验科, 安徽 合肥 230022
关键词:慢性肾脏病 肾功能损害严重程度 肿瘤特异性生长因子 
分类号:R692
出版年·卷·期(页码):2020·39·第二期(145-150)
摘要:

目的:探讨血清肿瘤特异性生长因子(TSGF)水平在慢性肾脏病(CKD)患者肾功能损害严重程度评估中的应用价值。方法:回顾性分析158例CKD患者(CKD组)与40例健康体检者(对照组)的临床资料和实验室指标,根据CKD分期将CKD组158例患者再分为肾功能轻度损害(CKD1~3)组和肾功能重度损害(CKD4~5)组两组。采用日立全自动生化仪008AS、希森美康全自动血细胞分析仪XN-1001检测各项实验室指标,采用相关和回归分析血清TSGF水平与胱抑素C (CYSC)、同型半胱氨酸(HCY)、D-二聚体(D-D)水平、中性粒细胞与淋巴细胞比值(NLR)、CKD分期、肾功能损害严重程度之间的相关性。结合受试者工作特征(ROC)曲线,比较血清TSGF水平与CYSC、HCY、D-D水平及NLR的曲线下面积(AUC),评估其在CKD患者早期肾功能损害诊断中的预测效能。结果:CKD组的TSGF水平显著高于对照组(P<0.05);肾功能轻度损害组的TSGF水平明显高于对照组(P<0.05),肾功能重度损害组较之肾功能轻度损害组TSGF水平进一步升高(P<0.05)。诊断CKD患者早期肾功能损害的ROC曲线中,TSGF的AUC显著大于HCY、NLR、D-D (P<0.05);TSGF与肾功能损害严重程度提高显著相关(OR=1.208,95%CI为1.003~1.456,P=0.047)。结论:血清TSGF可能是预测CKD患者早期肾功能损害及评估肾功能损害严重程度的一种新的生物标志物。

Objective: To investigate the application of tumor specific growth factor(TSGF) in evaluating the severity of renal impairment in patients with chronic kidney disease(CKD). Methods: The clinical data and laboratory indices of 158 cases of patients with CKD(CKD group) and 40 cases of healthy subjects(control group) were analyzed retrospectively. According to the stage of CKD, the patients were subdivided into two groups:mild impairment of renal function group and severe impairment of renal function group. The automatic biochemical analyzer 008AS of HITACHI and the automatic blood cell analyzer XN-1001 of SYSMEX were employed to detect the laboratory indicators. Regression and correlation analysis were used to analyze the correlation of TSGF with levels of CYSC, HCY,D-D, NLR, the stage of CKD and severity of renal impairment in CKD patients. The predictive efficacy of TSGF, CYSC, HCY, NLR and D-D in the diagnosis of early renal impairment in CKD patients was evaluated by comparing the area under the curve(AUC) of receiver operating characteristic(ROC) curve. Results: The levels of TSGF in CKD group were significantly higher than those in control group(P<0.05). TSGF levels in patients with mild impairment of renal function were significantly higher than those in control group(P<0.05), and the levels of TSGF in patients with severe impairment of renal function were significantly higher than those in patients with mild impairment(P<0.05). TSGF was positively correlated with TSGF, CYSC, HCY, NLR, D-D and the stage of patients with CKD(P<0.05). In the ROC curve for predicting early renal impairment in patients with CKD, the AUC of TSGF was significantly greater than that of HCY, NLR and D-D(P<0.05).TSGF was significantly correlated with increased severity of renal function impairment(OR=1.208,95%CI:1.003-1.456,P=0.047). Conclusion: TSGF may be a new biomarker for predicting early renal impairment and evaluating its severity in patients with CKD.

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