尿胰岛素样生长因子结合蛋白7在急性肾损伤中的诊断价值及意义

发布时间：2018-06-29 17:07

本文选题：AKI + IGFBP7　；参考：《石河子大学》2017年硕士论文

【摘要】：目的:探讨尿胰岛素样生长因子结合蛋白7(IGFBP7)在急性肾损伤(AKI)诊断中的价值和意义,为AKI的及时诊断、肾功能评估提供可靠依据。方法:选择2015年12月-2016年5月新疆石河子大学医学院第一附属医院住院及门诊患者为研究对象。严格按照纳入标准及排除标准,共入组AKI患者50例,慢性肾脏病(chronic kidney diseases,CKD)患者30例,与之性别、年龄、体重相匹配的健康体检者30例。收集入组患者的基础资料(性别、年龄等),所有入选者均于确诊后留取24h内第1次晨尿(中段尿)及晨起空腹血标本,生化分析仪检测血胱抑素C(serum Cystatin C,s Cys C)、血肌酐(Serum creatinine,Scr)水平(胶乳增强免疫透射比浊法检测s Cys C;酶法检测Scr),采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)检测尿IGFBP7的水平,整理三组所有研究资料统计学综合分析。结果:1.与正常组、CKD组相比,AKI组的尿IGFBP7水平显著升高,差异有统计学意义(P0.05);与正常组相比,AKI组s Cys C水平明显升高,差异有统计学意义(P0.05);与CKD组相比,AKI组s Cys C水平较CKD组稍升高,差异无统计学意义(P0.05);随AKI各期进展尿IGFBP7、血清s Cys C水平逐渐升高,各期之间差异具有统计学意义(P0.05)。2.直线相关分析显示:AKI组中尿IGFBP7与s Cys C及Scr呈正相关(r=0.782,P0.01;r=0.884,P0.01)。3.ROC曲线分析显示:在AKI诊断中,尿IGFBP7曲线下面积为0.889(95%CI 0.813~0.966,P0.01);s Cys C曲线下面积为0.877(95%CI 0.803~0.951;P0.01)。结论:1.尿IGFBP7在AKI患者中显著升高,且在诊断AKI方面有着较好的准确度和敏感性,故有望成为诊断AKI的新生物学标记物。2.尿IGFBP7随AKI各期进展逐渐升高,对AKI的分期有重要指导意义。
[Abstract]:Objective: to investigate the value and significance of urinary insulin-like growth factor binding protein 7 (IGFBP7) in the diagnosis of acute renal injury (AKI), and to provide reliable basis for the timely diagnosis of AKI and the evaluation of renal function. Methods: the inpatients and outpatients in the first affiliated Hospital of Medical College of Shihezi University of Xinjiang were selected from December 2015 to May 2016. According to the inclusion criteria and exclusion criteria, 50 patients with AKI, 30 patients with chronic kidney disease (chronic kidney disease), 30 healthy persons matched with sex, age and body weight were enrolled. The basic data (sex, age, etc.) of the patients were collected. The first morning urine (middle urine) and fasting blood samples were collected in 24 hours after diagnosis. Serum cystatin C (serum Cystatin C), serum creatinine (creatinine SCR) (latex enhanced transmission turbidimetric assay (RIA) and enzyme assay (SCR) were detected by biochemical analyzer, and the levels of urinary IGFBP7 were detected by enzyme-linked immunosorbent assay-linked immunosorbent assay (Elisa). All the data of three groups were analyzed statistically. The result is 1: 1. The level of urinary IGFBP7 in AK AKI group was significantly higher than that in normal control group (P0.05), the level of sCys C in AKI group was significantly higher than that in normal group (P0.05), the level of sCys C in AKI group was slightly higher than that in CKD group (P0.05), the level of sCys C in AKI group was slightly higher than that in CKD group (P0.05), the level of sCys C in AKI group was significantly higher than that in control group (P0.05). There was no significant difference (P0.05); with the progress of AKI, the level of serum sCys C gradually increased with the progression of AKI (P0.05). 2. Linear correlation analysis showed that there was a positive correlation between urinary IGFBP7 and sCys C and SCR (rn 0.782n P0.01P 0.01P 0.884P 0.01). 3. The area under the curve of urine IGFBP7 was 0.889 (95 CI 0.8130.966P0.01) in AKI group, and the area under the curve was 0.877 (95CI 0.8030.951 P0.01). Conclusion 1. Urinary IGFBP7 is significantly increased in AKI patients, and has good accuracy and sensitivity in the diagnosis of AKI, so it may become a new biological marker of AKI diagnosis. Urinary IGFBP7 increases gradually with the development of AKI, which is of great significance to the staging of AKI.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692.5

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