糖类抗原CA125、CA199、CA153在肾病综合征患者中的表达及相关影响因素分析

发布时间：2018-02-10 03:43

本文关键词： 肾病综合征浆膜腔积液低蛋白血症糖类抗原 125糖类抗原 199糖类抗原153　出处：《昆明医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的通过回顾性研究原发性肾病综合征患者在不同血浆白蛋白水平、肾功能水平以及伴浆膜腔积液等情况下,血清中糖类抗原(Cancer Associated Antigen125),CA125.(Cancer Associated Antigen199),CA199.(Cancer Associated Antigen153),CA153的浓度变化,并对影响以上3种糖类抗原可能的影响因素进行了统计学分析,为临床诊断糖类抗原升高的肾病综合征患者,提供诊断及治疗的科学依据。方法回顾性研究：收集既往2012年1月至2013年10月在昆明医科大学第一附属医院肾内科住院,出院时确诊为原发性肾脏病、各种临床检验资料完整、排外既往肿瘤病史、心血管疾病、内分泌疾病、全身免疫性疾病及病毒性肝炎、肺结核的患者150名,平均年龄(41.03±18.34)岁,其中男性患者74名,女性76名。对照组随机选取来我院体检的健康人群127名,平均年龄(42.46±15.69)岁,其中男性64名,女性63名。所有入选人员行肿瘤标志物全套、血生化检查。将患者组与正常对照组的3项肿瘤标志物CA125、 CA199、CA153水平进行比较,并根据有无浆膜腔积液、有无低蛋白血症、有无肾功能不全、有无绝经将NS患者组间3项肿瘤标志物水平及常规肾脏功能生化指标进行两两比较,并对NS组中可能影响肿瘤标志物水平因素进行相关性及危险因素分析。统计学方法采用SPSS17.0. 结果肾病综合征患者糖类抗原CA125、CA199、CA153阳性率及浓度水平均较正常对照组升高(P0.05)；肾病综合征组中生化指标白蛋白、尿素氮、血清肌酐、尿酸、血清肌酐清除率均较正常对照组有变化(P0.05)。在有无浆膜腔积液两组比较中,糖类抗原CA125差异具有统计学差异(P0.05),CA199、CA153差异无统计学意义(P0.05)：而该组生化指标比较中白蛋白、血清肌酐、尿素氮间差异具有统计学意义(P0.05),尿酸、肌酐清除率在两组中差异无统计学意义。在肾病综合征组有无低蛋白血症两组比较中,低蛋白血症组糖类抗原CA125、CA153水平高于非低蛋白血症组,两者差异具有统计学意义(P0.05),CA199间差异无统计学意义(P0.05)；两组生化指标比较,尿素氮、肌酐、尿酸、肌酐清除率间差异均无统计学意义(P0.05)。在肾病综合征组中不同性别患者中CA125、CA199、CA153间差异均无统计学意义；在肾病综合征组的女性患者中,有、无绝经组患者糖类抗原CA125、CA199、CA153间差异均无统计学意义(P0.05)。分别对3种糖类抗原的相关性及危险因素分析结果示：白蛋白、血清肌酐与CA125间存在统计相关(P0.05),CA125与血清肌酐呈正相关,与白蛋白呈负相关；对其危险因素分析示,白蛋白、血清肌酐、肌酐清除.率、有无浆膜腔积液是肾病综合症患者CA125升高的影响因素(P0.05),其中肌酐清除率是保护性因素(OR1),其余为危险因素(OR1)；CA199与白蛋白、血肌酐、尿素氮、尿酸、肌酐清除率间无相关性(P0.05),对升高危险因素分析,以上研究因素亦不是糖类抗原CA199发病的危险因素(OR1)；CA153与血浆白蛋白呈负相关(P0.005),危险因素分析则提示血清肌酐水平是其发病危险因素(OR1)。结论肾病综合征时患者血清糖类抗原CA125、CA199、CA153浓度可有不同程度升高,其中糖类抗原CA125与血清肌酐呈正相关,与白蛋白呈负相关；血浆白蛋白、血清肌酐、有浆膜腔积液是CA125升高的危险因素,肌酐清除率正常则是其保护性因素。糖类抗原CA199与本研究中可能影响因素间不存在相关性,本研究中可能因素亦不是其升高的危险因素。对糖类抗原CA153研究则发现,血浆白蛋白与其呈负相关,而血清肌酐水平则是其发病危险因素。
[Abstract]:Objective To retrospectively study the patients with primary nephrotic syndrome in different levels of plasma albumin, renal function and the level of patients with serous cavity effusion under conditions of serum carbohydrate antigen (Cancer Associated Antigen125), CA125. (Cancer Associated Antigen199), CA199. (Cancer Associated Antigen153), the change of CA153 concentration, and the influence of the above factors effect of 3 kinds of carbohydrate antigens analyzed for clinical diagnosis, increased carbohydrate antigen in patients with nephrotic syndrome, provide scientific basis for diagnosis and treatment.
Methods: from January 2012 to October 2013 had been collected from Department of nephrology in First Affiliated Hospital of Kunming Medical University, was diagnosed as primary renal disease, the clinical testing data integrity, exclusion of known history of cancer, cardiovascular diseases, endocrine diseases, systemic autoimmune diseases and viral hepatitis, pulmonary tuberculosis in 150 patients, average age (41.03 + 18.34) years old, of which 74 were male, 76 were female. The control group were randomly selected from healthy people in our hospital for 127 persons, the average age (42.46 + 15.69) years, 64 males and 63 females. All the selected staff for tumor marker set, blood biochemical examination. 3 tumor patients group and normal control group markers CA125, CA199, CA153 levels were compared, and according to the presence or absence of serous effusion, there is no hypoproteinemia, without renal dysfunction, there is no NS between the two groups of patients postmenopausal 3 The level of tumor markers and routine renal function and biochemical indexes were compared by 22. The correlation and risk factors of tumor markers in group NS were analyzed. The statistical method was SPSS17.0..
Results the patients with nephrotic syndrome antigen CA125, CA199, CA153 positive rate and the concentration levels were increased compared to normal control group (P0.05); nephrotic syndrome syndrome group and biochemical indexes of albumin, urea nitrogen, serum creatinine, uric acid, serum creatinine clearance rate were higher than the normal control group (P0.05). The change in no serosa the comparison between the two groups in the effusion, carbohydrate antigen CA125 had a significant difference (P0.05, CA199), there was no significant difference of CA153 (P0.05), albumin, and the set of biochemical indicators in serum creatinine, urea nitrogen difference have statistical significance (P0.05), uric acid, creatinine clearance rate in the two groups had no difference statistical significance. In nephrotic syndrome group without hypoproteinemia in two groups, hypoproteinemia group carbohydrate antigen CA125, CA153 levels higher than the non hypoproteinemia group, the difference has statistical significance (P0.05), CA199 was no difference. Yi (P0.05); compared two groups of blood urea nitrogen, creatinine, uric acid, creatinine clearance rate and there were no significant difference (P0.05). CA199 in nephrotic syndrome group in different gender patients in CA125, CA153, and there were no significant difference in female patients with nephrotic syndrome; syndrome group, have no, menopause group patients with carbohydrate antigen CA125, CA199, CA153 and there were no significant difference (P0.05). The correlation and risk of the 3 kinds of carbohydrate antigen factor analysis showed that albumin, serum creatinine has statistical correlation between CA125 and CA125 (P0.05), and serum creatinine were positively correlated, negatively correlated with albumin; the risk factor analysis, albumin, serum creatinine, creatinine clearance rate. There is no effusion, influencing factors of patients with nephrotic syndrome CA125 (P0.05), which elevated creatinine clearance is a protective factor (OR1) and other risk factors (OR1); CA199 and albumin, serum creatinine, urea nitrogen, uric acid, creatinine clearance rate (P0.05), no correlation between the increase of analysis of risk factors, risk factors of above factors are also not carbohydrate antigen CA199 (OR1); the incidence of CA153 was negatively correlated with serum albumin (P0.005), risk factors analysis suggested that serum creatinine level is the risk factors (OR1).
Conclusion nephrotic syndrome patients serum carbohydrate antigen CA125, CA199, CA153 concentration can be increased to different extent, the carbohydrate antigen CA125 and serum creatinine were positively correlated negatively correlated with albumin; plasma albumin, serum creatinine, with serous effusion are the risk factors of elevated CA125, normal creatinine clearance is the protective possible factors. There is no correlation between influence factors and carbohydrate antigen CA199 in this study, possible factors in this research is not the elevated risk factors. The study of CA153 carbohydrate antigens that are negatively correlated with plasma albumin, and serum creatinine levels are risk factors.

【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692

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