血清糖类抗原125检测在肾脏病患者中的临床意义

Clinical significance of level of serum carbohydrate antigen 125 in patients with kidney diseases

目的探讨影响肾脏病患者血清糖类抗原125(CA125)水平的相关因素及其升高的可能机制。方法回顾性分析2009年10月至2010年10月本院肾内科行血清CA125检测的住院患者138例的临床资料。按照血清肌酐水平及有无透析治疗分为肾功能正常组(RN组)、肾功能不全未透析组(CRF组)及维持性血液透析组(MHD组)。根据血清CA125正常值分为阳性组和阴性组。结果 CRF组及MHD组血清CA125水平分别为19.83(51.96)kU/L和30.44(78.29)kU/L,显著高于RN组12.67(10.68)kU/L(P<0.01),而CRF组及MHD组间血清CA125水平差异无统计学意义(P>0.05);CRF组及MHD组伴有浆膜腔积液的比例分别为39.1%和46.4%,显著高于RN组6.3%(P<0.01),而CRF组及MHD组间伴有浆膜腔积液的比例差异无统计学意义(P>0.05)。血清CA125阳性组的浆膜腔积液、肾病综合征、低白蛋白血症、大量蛋白尿及肾功能不全的比例比阴性组高(P<0.01)。5例行胸腔穿刺的患者胸水CA125水平均高于其血清CA125水平。Logistic回归分析显示肾病综合征和合并浆膜腔积液是血清CA125升高的危险因素(OR=33.867,95%CI=11.48～99.94和OR=4.174,95%CI=1.176～14.810)。结论肾脏病患者中血清CA125水平升高较常见,合并浆膜腔积液是引起血清CA125水平升高的重要因素。

Objective To investigate related factors influencing the level of serum carbohydrate antigen（CA）125 and the possible mechanism in patients with kidney diseases. Methods Clinical data of 138 patients with kidney diseases from Oct.2009 to Oct.2010 in the hospital and their levels of serum CA125 were analyzed.The patients were divided into normal renal function group,chronic renal failure（CRF） group and maintenance hemodialysis（MHD） group according to the levels of serum creatinine and with or without hemodialysis.The patients were divided into CA125 positive group and negative group according to the normal value of serum CA125. Results The levels of serum CA125 in CRF group and MHD group were both significantly higher than that in normal renal function group,19.83（51.96） kU/L and 30.44（78.29） kU/L vs 12.67（10.68） kU/L（P0.01）.There was no significant difference in serum CA125 between CRF group and MHD group（P0.05）.The ratios of serosal fluid in CRF group and MHD group were both significantly higher than that in normal renal function group,39.1% and 46.4% vs 6.3%（P0.01）.There was no significant difference in the ratios of serosal fluid between CRF group and MHD group（P0.05）.The ratios of serosal fluid,nephrotic syndrome,hypoalbuminemia,massive proteinuria and renal disfunction were significantly higher in CA125 positive group than those in negative group（P0.01）.In five patients,the levels of CA125 in pleural effusion were higher than those in serum.Nephrotic syndrome and serosal fluid were risk factors for elevated serum CA125（OR=33.867,95%CI=11.48-99.94 and OR=4.174,95%CI=1.176-14.810）. Conclusion Elevated levels of serum CA125 are more observed in patients with kidney diseases.Serosal fluid is an important factor that can cause elevated levels of serum CA125.