原发性局灶节段性肾小球硬化患者血清可溶性尿激酶型纤溶酶原激活物受体检测及其诊断价值

发布时间：2018-10-15 14:14

【摘要】：目的探讨血清可溶性尿激酶型纤溶酶原激活物受体(su PAR)水平检测对于诊断原发性局灶节段性肾小球硬化(FSGS)的价值。方法选取常德市职业技术学院附属第一医院于2011年1月—2014年1月收治的临床病理资料完整的103例肾病综合征(NS)患者,包括34例原发性膜性肾病(MN)患者(MN组)、30例原发性FSGS患者(FSGS组)、26例原发性微小病变型肾病(MCD)患者(MCD组)和13例Ig A肾病患者(Ig AN组)。检测4组患者血清中su PAR水平,并分析FSGS组患者血清su PAR水平与患者临床资料的关系;通过受试者工作特征曲线(ROC曲线)分析su PAR诊断FSGS、MN、MCD的ROC曲线下面积(AUC)、灵敏度和特异度。结果 4组患者性别构成、血红蛋白、血清清蛋白、肌酸酐、24 h尿蛋白定量比较,差异无统计学意义(P0.05)。4组患者年龄、肾小球滤过率(GFR)、su PAR水平比较,差异有统计学意义(P0.05)。FSGS组患者GFR低于MN组、MCD组和Ig AN组,MN组患者GFR低于MCD组和Ig AN组(P0.05);FSGS组患者血清su PAR水平高于MN组、MCD组和Ig AN组(P0.05);MN组患者血清su PAR水平与MCD组和Ig AN组患者比较,差异无统计学意义(P0.05)。FSGS组患者血清su PAR水平与年龄和肌酸酐呈正相关(P0.05),与GFR呈负相关(P0.05);血清su PAR水平与性别、血红蛋白、血清清蛋白、24 h尿蛋白定量无直线相关性(P0.05)。su PAR诊断FSGS的AUC为0.723〔95%CI(0.702,0.769)〕,而su PAR诊断MCD和MN的AUC分别为0.455〔95%CI(0.382,0.486)〕和0.493〔95%CI(0.425,0.538)〕。su PAR诊断FSGS的临界值为3 542 ng/L,其灵敏度为79%,特异度为78%。结论血清su PAR水平3 542 ng/L对FSGS的诊断具有较大指导意义,su PAR有望成为辅助诊断FSGS的血清标志物。
[Abstract]:Objective to investigate the value of serum soluble urokinase type plasminogen activator receptor (su PAR) in the diagnosis of primary focal glomerulosclerosis (FSGS). Methods 103 patients with nephrotic syndrome (NS) who were admitted to the first affiliated Hospital of Changde Vocational and Technical College from January 2011 to January 2014 were selected. There were 34 patients with primary membranous nephropathy (MN group), 30 patients with primary FSGS (FSGS group), 26 patients with primary minimal change nephropathy (MCD group) and 13 patients with Ig A nephropathy (Ig AN group). The serum su PAR level in the four groups was detected, and the relationship between the serum su PAR level in the FSGS group and the clinical data was analyzed, and the sensitivity and specificity of (AUC), under the ROC curve for su PAR diagnosis of FSGS,MN,MCD were analyzed by the ROC curve. Results there was no significant difference in sex composition, hemoglobin, serum albumin, creatinine and 24 h urinary protein between the four groups (P0.05). The age and glomerular filtration rate (GFR), su PAR) level of the 4 groups were compared. The difference was statistically significant (P0.05) GFR in). FSGS group was lower than that in MN group, MCD group and Ig AN group, GFR level in MN group was lower than that in MCD group and Ig AN group (P0.05) the level of serum su PAR in); FSGS group was higher than that in MN group, MCD group and Ig AN group (P0.05) in); MN group and MCD group. Comparison of patients in Ig AN group, There was no significant difference between serum su PAR level and age and creatinine (P0.05), but negative correlation with GFR (P0.05), serum su PAR level and gender, hemoglobin, serum su PAR level in). FSGS group were positively correlated with age and creatinine (P0.05), but negatively correlated with GFR (P0.05). There was no linear correlation between serum albumin and 24 h urine protein quantification (P0.05 AUC of FSGS was 0.723 (95%CI (0.702 卤0.769), AUC of su PAR was 0.455 (95%CI (0.382 卤0.486) and 0.493 (critical value of 95%CI (0.425 卤0.538). Su PAR) for FSGS was 3.542ng/L, the sensitivity was 79.05 ng/L, the specificity was 78th). Conclusion the serum su PAR level of 3 542 ng/L is of great significance for the diagnosis of FSGS., su PAR is expected to be a serum marker for auxiliary diagnosis of FSGS.
【作者单位】：湖南省常德市职业技术学院附属第一医院肾内科;中南大学湘雅二医院肾脏病研究所;
【基金】：湖南省常德市科技局重点资助项目(2012ZX08)
【分类号】：R692.6

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