文章摘要
丁 一,李 君,刘倩倩,谢丹丹,花晓琳.尿神经突起导向因子1、肾损伤分子-1、视黄醇结合蛋白水平与妊娠期高血压疾病早期肾损伤的关系研究[J].,2021,(14):2643-2646
尿神经突起导向因子1、肾损伤分子-1、视黄醇结合蛋白水平与妊娠期高血压疾病早期肾损伤的关系研究
Study on the Relationship between Urinary Neurite Guidance Factor 1, Kidney Damage Molecule-1, Retinol Binding Protein Levels and Early Renal Damage in Hypertensive Disorder Complicating Pregnancy
投稿时间:2021-01-06  修订日期:2021-01-31
DOI:10.13241/j.cnki.pmb.2021.14.009
中文关键词: 妊娠期高血压疾病  神经突起导向因子1  肾损伤分子-1  视黄醇结合蛋白  影响因素
英文关键词: Hypertensive disorder complicating pregnancy  Urinary neurite guidance factor 1  Kidney injury molecule-1  Retinol binding protein  Influence factors
基金项目:上海市卫计委科研基金项目(201640366)
作者单位E-mail
丁 一 同济大学附属第一妇婴保健院产科 上海 201204 dingyidyk8@126.com 
李 君 同济大学附属第一妇婴保健院产科 上海 201204  
刘倩倩 同济大学附属第一妇婴保健院产科 上海 201204  
谢丹丹 同济大学附属第一妇婴保健院产科 上海 201204  
花晓琳 同济大学附属第一妇婴保健院产科 上海 201204  
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中文摘要:
      摘要 目的:研究尿神经突起导向因子1(Netrin-1)、肾损伤分子-1(Kim-1)、视黄醇结合蛋白(RBP)水平与妊娠期高血压疾病(HDCP)早期肾损伤的关系。方法:将我院从2017年2月~2020年2月收治的HDCP患者80例纳入研究,按照HDCP严重程度分作妊娠期高血压组22例、轻度子痫前期组32例、重度子痫前期组26例,另随机选取同期于我院接受规律孕产检以及分娩正常妊娠孕妇40例作为正常妊娠组,检测并比较各组尿Netrin-1、Kim-1、RBP水平。此外,将HDCP患者按照是否出现早期肾损伤分作肾功能损伤组42例和肾功能正常组38例,比较两组尿Netrin-1、Kim-1、RBP以及肾功能指标水平,并进行相关性分析,通过Logistic回归分析HDCP早期肾损伤的影响因素。结果:正常妊娠组、妊娠期高血压组、轻度子痫前期组、重度子痫前期组尿Netrin-1水平呈逐渐降低趋势,而尿Kim-1、RBP水平均呈逐渐升高趋势,多组数据间两两对比差异均有统计学意义(均P<0.05)。肾功能损伤组尿Netrin-1水平低于肾功能正常组,而尿Kim-1、RBP以及血尿素氮、血肌酐、24 h尿白蛋白排出量(UAE)水平均明显高于肾功能正常组(均P<0.05)。经Pearson相关性分析可得:HDCP早期肾损伤患者尿Netrin-1水平和血尿素氮、血肌酐、UAE均呈负相关关系,而Kim-1、RBP水平和血尿素氮、血肌酐、UAE均呈正相关关系(均P<0.05)。经Logistic回归分析发现:尿Netrin-1是HDCP早期肾损伤的保护因素,而尿Kim-1、RBP是HDCP早期肾损伤的危险因素(均P<0.05)。结论:随着尿Netrin-1水平的降低以及Kim-1、RBP水平的升高,HDCP早期肾损伤风险越高,检测尿Netrin-1、Kim-1、RBP水平可能有助于评估HDCP的病情严重程度和肾功能损伤。
英文摘要:
      ABSTRACT Objective: To study the relationship between urinary neurite guidance factor 1 (Netrin-1), kidney injury molecule-1 (KIM-1) and retinol binding protein (RBP) levels and early renal injury in hypertensive disorder complicating pregnancy (HDCP). Methods: A total of 80 patients with HDCP who were admitted to our hospital from February 2017 to February 2020 were included in this study. According to the severity of HDCP, the patients were divided into gestational hypertension group with 22 cases, mild preeclampsia group with 32 cases and severe preeclampsia group with 26 cases. Another 40 cases of normal pregnant women who received regular pregnancy and childbirth tests in our hospital during the same period were randomly selected as the normal pregnancy group. The urinary Netrin-1, Kim-1 and RBP levels in each group were detected and compared. In addition, patients with HDCP were divided into renal function injury group with 42 cases and renal function normal group with 38 cases according to the occurrence of early renal injury. The urinary Netrin-1, Kim-1, RBP and renal function indexes levels were compared between the two groups, and the correlation analysis was carried out. The influencing factors of early renal injury in HDCP were analyzed by Logistic regression. Results: The urinary Netrin-1 levels in normal pregnancy group, gestational hypertension group, mild preeclampsia group and severe preeclampsia group showed a gradually decreasing trend, while the urinary Kim-1 and RBP levels showed a gradually increasing trend, there were statistically significant differences in the pairwise comparison between multiple groups of data (all P<0.05). The urinary Netrin-1 level in renal function injury group was lower than that in renal function normal group, while the urinary Kim-1, RBP, blood urea nitrogen and serum creatinine and 24 h Urinary albumin excretion (UAE) levels in renal function injury group were significantly higher than those in renal function normal group (all P<0.05). According to Pearson correlation analysis, urinary Netrin-1 level was negatively correlated with blood urea nitrogen and serum creatinine, UAE in early renal injury in HDCP, while Kim-1, RBP levels were positively correlated with blood urea nitrogen and serum creatinine, UAE (all P<0.05). Logistic regression analysis showed that urinary Netrin-1 was a protective factor for early renal injury in HDCP, while Kim-1 and RBP were risk factors for early renal injury in HDCP (all P<0.05). Conclusion: With the decrease of urinary Netrin-1 level and the increase of Kim-1 and RBP levels, the risk of early renal injury in HDCP is higher, detection of urinary Netrin-1, Kim-1, RBP levels may be helpful to evaluate the severity of HDCP and renal function damage.
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