尿血管紧张素原与慢性肾脏病的关联研究

发布时间：2018-08-01 13:25

【摘要】：目的:探讨尿血管紧张素原(AGT)与慢性肾脏病(CKD)的关联性,探讨尿AGT对慢性肾脏病的诊断的意义。方法:从慢性肾脏病横断面调查的资源标本库中抽取CKD和非CKD样本,按照估算的肾小球滤过率(eGFR单位:ml/min/1.73m2)将CKD患者分为3组:正常组(eGFR≥90),临界组(60≤eGFR90),下降组(30≤eGFR60)。CKD组和非CKD组中在收缩压80-220mmHg区间,按每隔20 mmHg进行分组。尿AGT用酶联免疫吸附测定法(ELISA)进行检测。单因素方差分析法分析组间差异,多因素分析采用多重线性回归分析法。结果:资料完整的95名CKD患者和413名非CKD对照组进入本研究。CKD组尿AGT明显高于非CKD组(243.97±47.86 vs 158.43±25.14t=16.892 P0.01);随着肾小球滤过率下降,尿AGT呈升高趋势,正常组、临界组和下降组尿AGT分别为213.63±34.47ng/L,251.39±17.17ng/L,314.97±27.58ng/L,各组间有显著差异(F=81.103 P0.01)。在同一血压水平下,CKD组中尿AGT均显著高于非CKD组,差异有统计学意义(P0.01);CKD组中随着收缩压升高,尿AGT水平进一步升高,收缩压在140-160mmHg和160-180mmHg区间段,差异有统计学意义(P0.01)。多重线性回归分析显示,尿AGT与尿白蛋白/肌酐和血肌酐呈正相关,与eGFR呈负相关。结论:慢性肾脏病患者尿AGT高于非CKD者;在CKD患者中随着收缩压升高,尿AGT水平进一步升高;尿AGT与尿白蛋白/肌酐和血肌酐呈正相关,与eGFR呈负相关;提示尿血管紧张素原可作为慢性肾脏病早期预测和病程进展的生物学标志物。
[Abstract]:Objective: To investigate the association between urinary angiotensinogen (AGT) and chronic renal disease (CKD), and to explore the significance of urinary AGT in the diagnosis of chronic renal disease. Methods: CKD and non CKD samples were extracted from the resource Specimen Bank of the cross-sectional study of chronic kidney disease, and CKD patients were divided into 3 groups according to the estimated glomerular filtration rate (eGFR unit: ml/min/1.73m2). Group (eGFR > 90), critical group (60 < < eGFR90), decreased group (30 < eGFR60).CKD and non CKD group in systolic pressure 80-220mmHg interval, every 20 mmHg were grouped. Urine AGT was detected by enzyme linked immunosorbent assay (ELISA). Single factor analysis of variance analysis was used to analyze the difference between groups and multiple linear regression analysis was adopted. The urine AGT of 95 CKD patients and 413 non CKD controls was significantly higher than that in the non CKD group (243.97 + 47.86 vs 158.43 + 25.14t=16.892 P0.01). With the decrease of the glomerular filtration rate, the urine AGT showed a tendency to increase. The normal group, the critical group and the descending group of AGT were 213.63 + 34.47ng/L, 251.39 + 17.17ng/L, 314.97 +, respectively. There were significant differences between each group (F=81.103 P0.01). In the same blood pressure level, the urine AGT in CKD group was significantly higher than that in the non CKD group, and the difference was statistically significant (P0.01). In the CKD group, the level of urinary AGT increased with the increase of systolic pressure, and the systolic pressure was in the 140-160mmHg and 160-180mmHg segments, the difference was statistically significant (P0.01). Multiple linear regression scores were found in group CKD. The results showed that urinary AGT was positively correlated with urinary albumin / creatinine and creatinine and negatively correlated with eGFR. Conclusion: the urine AGT of patients with chronic kidney disease is higher than that of non CKD; in patients with CKD, the level of urine AGT increases with the increase of systolic pressure; urinary AGT is positively related to urinary albumin / creatinine and creatinine, and is negatively related to eGFR, suggesting urinary angiotensinogen. It can be used as a biomarker for early prediction and progression of chronic kidney disease.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692

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