高血压早期肾损伤患者血清尿调节素变化及临床意义

艾文婷; 符莹莹; 姜保周

doi:10.13201/j.issn.1009-5918.2018.09.006

高血压早期肾损伤患者血清尿调节素变化及临床意义

- 1. 陕西省人民医院心内科(西安, 710068);
- 2. 陕西省人民医院急诊内科
基金项目:
陕西省重点研发计划 (No:2017SF-039)

详细信息

通讯作者: 姜保周,E-mail:jbzxjedu@126.com

中图分类号: R544.1

收稿日期: 2018-07-03

The changes of serum uromodulin of early renal damage in patients with essential hypertension and its clinical significance

- 1. Department of Cardiology, Shaanxi People's Hospital, Shaanxi, Xi'an, 710068, China;
- 2. Department of Emergency Internal, Shaanxi People's Hospital

More Information

Corresponding author: JIANG Baozhou, E-mail: jbzxjedu@126.com

Received Date: 03 July 2018

摘要

摘要: 目的:探讨血清尿调节素(UMOD)检测在原发性高血压病患者早期肾损伤中的诊断价值。方法:选择2017-01-2018-01期间在我科治疗的236例原发性患者纳入研究,按照肾小球滤过率(GFR)将患者分为3组,中度及以上肾功能损伤组[A组,GFR<60 ml/(min·1.73 m²)],轻度肾功能损伤组[B组,60 ml/(min·1.73 m²) ≤ GFR <90 ml/(min·1.73 m²)]和肾功能正常组[C组,GFR ≥ 90 ml/(min·1.73 m²)]。另选择100例同期于我院行健康体检志愿者作为对照组(D组)。采用酶联免疫吸附试验法(ELISA)检测各组标本UMOD水平。结果:A组血清UMOD水平显著低于B组及C组,B组血清UMOD水平明显低于C组(均P<0.05)。血清UMOD与GFR呈正相关关系(r=0.387,P<0.01),与尿素氮、尿酸、肌酐、胱抑素C和尿微量白蛋白均呈负相关关系(r=-0.206、-0.175、-0.318、-0.352、-0.284,均P<0.05)。根据受试者工作特征(ROC)曲线,血清UMOD诊断原发性高血压患者早期肾损伤的最佳临界点为127.3 mg/ml,对应敏感性、特异性分别为72.5%和83.8%,ROC曲线下面积为0.816。结论:血清UMOD可能成为原发性高血压患者早期肾损伤新的诊断指标之一。
- 尿调节素 /
- 原发性高血压 /
- 肾功能损伤 /
- ROC曲线分析
Abstract: Objective:To observe the diagnostic value of serum Uromodulin(UMOD)on early renal damage in patients with essential hypertension. Method:Two hundred and thirty-six essential hypertension patients in our hospital from January 2017 to January 2018 were selected into this study.According the glomerular filtration rate,they were divided into 3 groups,group of moderate and above renal damage[A group,GFR<60 ml/(min·1.73 m²)],group of mild renal damage[B group,60 ml/(min·1.73 m²) ≤ GFR<90 ml/(min·1.73 m²)]and group of normal kidney function[C group,GFR ≥ 90 ml/(min·1.73 m²)].Meanwhile,100 healthy volunteers were also selected into this study as control(D group).ELISA was used to detect serum levels of UMOD. Result:The serum UMOD level in the A group was lower than those of in B group and C group(both P<0.05).The serum UMOD level in the B group was also lower than that of C group(P<0.05).The serum UMOD level was significantly positively related to GFR(r=0.387,P<0.01).Meanwhile,serum UMOD level was significantly inversely associated with Urea nitrogen,uric acid,creatinine,cystatin C and urinary microalbumin(r=-0.206,-0.175,-0.318,-0.352,-0.284,all P<0.05).Based on the ROC curve,the boundary value of serum UMOD was 127.3 mg/ml for diagnosing early renal damage in patients with essential hypertension.The sensitivity and specificity of serum UMOD in diagnosis of early renal damage were 72.5% and 83.8%,respectively.The area under the ROC curve was 0.816 of serum UMOD in diagnosis of early renal damage in patients with essential hypertension.Conclusion:The serum UMOD may be applied to burst diagnosis of early renal damage in patients with essential hypertension.
- uromodulin /
- essential hypertension /
- renal damage /
- ROC curve

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参考文献(13)

[1]	陈李萨, 李萍萍, 刘健.原发性高血压合并慢性肾脏病的危险因素分析[J].肾脏病与透析肾移植杂志, 2013, 22 (3):213-218.
[2]	Cui J, Wan J, You D, et al.Interstitial complement C3 activation and macrophage infiltration in patients with hypertensive nephropathy[J].Clin Nephrol, 2017, 88 (12):328-337.
[3]	Dominik S, Matthias B, Victor H, et al.Plasma Uromodulin Correlates With Kidney Function and Identifies Early Stages in Chronic Kidney Disease Patients:[J].Medicine, 2016, 95 (10):e3011.
[4]	Devuyst O, Olinger E, Rampoldi L.Uromodulin:from physiology to rare and complex kidney disorders[J].Nat Rev Nephrol, 2017, 13 (9):525-544.
[5]	Satanovskij R, Bader A, Block M, et al.A new missense mutation in UMOD gene leads to severely reduced serum uromodulin concentrations-A tool for the diagnosis of uromodulin-associated kidney disease.[J].Clin Biochem, 2017, 50 (3):155-158.
[6]	Leiherer A, Muendlein A, Saely C H, et al.Serum uromodulin is associated with impaired glucose metabolism[J].Medicine, 2017, 96 (5):e5798.
[7]	中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华心血管病杂志, 2011, 39 (7):701-708.
[8]	Leiherer A, Muendlein A, Saely C H, et al.The value of uromodulin as a new serum marker to predict decline in renal function.[J].J Hypertens, 2017, 36 (1):110-118.
[9]	Yoshihara A, Iwasaki M, Miyazaki H, et al.Bidirectional relationship between renal function and periodontal disease in older Japanese women[J].J Clin Periodontol, 2016, 43 (9):720-726.
[10]	石红光, 赵学智.尿调节素相关肾病[J].中华肾脏病杂志, 2013, 29 (7):542-546.
[11]	Köttgen A, Glazer N L, Dehghan A, et al.Multiple loci associated with indices of renal function and chronic kidney disease.[J].Nat Genet, 2009, 41 (6):712-717.
[12]	Risch L, Lhotta K, Meier D, et al.The serum uromodulin level is associated with kidney function[J].Clin Chem Lab Med, 2014, 52 (12):1755-1761.
[13]	Ku śnierzcabala B, Galabłądzińska A, Mazurlaskowska M, et al.Serum Uromodulin Levels in Prediction of Acute Kidney Injury in the Early Phase of Acute Pancreatitis[J].Molecules, 2017, 22 (6):E988.