| 张伟东,陆雨菲,李 芳,朱博文,宋娜娜,朱启帆,李 捷,赵 栓,丁小强,蔡洁茹.uKIM-1、uβ2-MG与血UA在肾功能不全患者中的诊断价值研究[J].,2024,(23):4428-4433 |
| uKIM-1、uβ2-MG与血UA在肾功能不全患者中的诊断价值研究 |
| The Value of uKIM-1, uβ2-MG and Serum UAin the Diagnosis of Renal Dysfunction |
| 投稿时间：2024-05-17 修订日期：2024-06-10 |
| DOI：10.13241/j.cnki.pmb.2024.23.006 |
| 中文关键词: 血尿酸 β2微球蛋白 uKIM-1 肾功能不全 相关性分析 |
| 英文关键词: Serum uric acid Urine ?茁2-microglobulin Urine KIM-1 Renal dysfunction Correlation analysis |
| 基金项目:复旦大学附属中山医院青年科学基金项目（2023ZSQN44）；国家自然科学基金项目（82270719）；
上海市申康医院发展中心"上海市肾脏内科联盟"项目（SHDC2202230） |
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| 中文摘要: |
| 摘要 目的：明确血尿酸（Uric Acid，UA）、尿β2微球蛋白（urine ?茁2-microglobulin，uβ2-MG）和尿肾损伤分子-1（urine Kidney Injury Molecule-1，uKIM-1）对肾功能不全患者的诊断价值。方法：采用横断面研究设计，选取2022年3月1日至2022年8月31日在复旦大学附属中山医院肾内科门诊就诊且诊断为肾功能不全的患者为研究对象，采用酶联免疫吸附法检测uKIM-1水平和uβ2-MG水平，通过电子病历系统提取患者血UA、血肌酐（creatinine，Cr）、尿Cr等指标。依据24小时尿蛋白（24-hour urine protein，24h-UP）和肾小球滤过率（estimated Glomerular Filtration Rate，eGFR）将入组患者分为三类：蛋白尿型、eGFR降低型、慢性肾脏病（Chronic Kidney Disease, CKD）极高危型。比较不同类型患者组间人口学及临床特征，采用Logistic回归模型分析血UA/Cr、uβ2-MG、uKIM-1/Cr与肾损伤相关指标的关联，根据ROC曲线评估血UA/Cr、uβ2-MG、uKIM-1/Cr对肾功能不全患者的临床诊断价值。结果：经年龄、性别校正Logistic回归模型提示血UA/Cr和uβ2-MG与CKD极高危型呈显著相关性，而uKIM-1/Cr与各类肾功能不全均无统计学关联。ROC曲线分析显示血UA/Cr、uβ2-MG、uKIM-1/Cr在评估eGFR降低型肾功能不全时曲线下面积（Area Under the Curve，AUC）分别为0.887、0.970、0.720；评估CKD极高危时AUC值分别为0.868、0.821、0.684。结论：血UA/Cr对CKD、uβ2-MG对eGFR降低型肾功能不全具有较高的诊断价值，建议临床早期开展相关指标监测，及时采取干预措施、有效防治肾损伤进展。 |
| 英文摘要: |
| ABSTRACT Objective: To determine the diagnostic value of serum uric acid (UA), urine β2-microglobulin (uβ2-MG) and urine kidney injury molecule-1 (uKIM-1) in patients with renal dysfunction. Methods: The study was cross-sectional designed. Clinical, laboratory and histologic data of renal insufficient patients from the department of Nephrology, Zhongshan Hospital, China, from March 1, 2022, to August 31, 2022 were collected. Demographic, laboratory, and pathological information were extracted, and uKIM-1, uβ2-MG levels were detected by enzyme-linked immunosorbent assay. Serum UA, urine Cr and serum Cr were extracted by electronic medical record system. According to the 24-hour urine protein (24h-UP) and estimated glomerular filtration rate (eGFR), the enrolled patients were divided into three categories: proteinuria, eGFR-decreasing, and extremely high-risk of chronic kidney disease (CKD). Compare the demographic and clinical characteristics of kidney insufficient patients among different groups, use logistic regression model to analyze the correlation between serum UA/Cr, uβ2-MG, uKIM-1 and kidney injury related indicators, and evaluate the clinical diagnostic value of serum UA/Cr, uβ2-MG, and uKIM-1 for patients of renal dysfunction based on the ROC curve. Results: The logistic regression model adjusted for age and gender showed that UA/Cr and uβ2-MG were significantly correlated with extremely high-risk of CKD, while uKIM-1/Cr was not statistically correlated with all renal dysfunction outcomes. ROC curve analysis showed that the area under the curve (AUC) of UA/Cr, uβ2-MG and uKIM-1/Cr in evaluating eGFR-reduced renal dysfunction were 0.887, 0.970, and 0.720 respectively. The AUC of extremely high-risk of CKD were 0.868, 0.821 and 0.684 respectively. Conclusion: Serum UA/Cr have high diagnostic value for extremely high-risk of CKD, and uβ2-MG have high diagnostic value for eGFR-decreasing renal dysfunction. It is recommended to carry out relevant index follow-up in early clinical stage to effectively prevent the progression of kidney injury. |
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