sCD_(146)与慢性肾脏病的关系及其临床意义的研究

Relationship and Clinical Significance between Soluble CD_(146) and Chronic Kidney Disease

目的:探讨外周血sCD146水平在慢性肾脏病(CKD)中的意义及其与肾功能其他相关指标的关系。方法:入选101例CKD患者,CKD1期28例,CKD2期25例,CKD3期16例,CKD4期14例,CKD5期18例,(无血透患者)。设健康对照组20例。采用ELISA法检测sCD146水平。分析sCD146在CKD各期中的变化及其与肾功能相关指标的关系。结果:各组CKD患者sCD146水平[CKD1(218.46±34.31)ng/ml,CKD2(245.94±21.82)ng/ml,CKD3(273.99±21.87)ng/ml,CKD4(295.55±21.79)ng/ml,CKD5(326.55±26.75)ng/ml],均显著高于对照组(196.22±30.83)ng/ml。sCD146水平随着CKD1～5期进展升高,P<0.05。相关分析显示sCD146与Scr、BUN、β2-MG、CysC水平呈正相关(r分别为:0.676,0.680,0.685,0.604),与eGFR、Hb呈负相关(r分别为:-0.802,-0.586)。多因素逐步回归分析显示eGFR、Scr是影响sCD146的独立因素。结论:sCD146与CKD肾脏血管内皮损伤密切相关;sCD146较好地反映了CKD患者肾功能的进展及严重程度;sCD146能在一定程度上反映肾脏内皮细胞的早期损伤情况,其能否作为检测CKD患者肾功能损伤新的内源性标志物,有待进一步研究。

Objective：To detect the level of soluble CDl46（sCD146）and explore its relationship with chronic kidney disease（CKD）.Methods：Methods：A total of 101 patients with CKD,including 28 cases of CKD1,26 cases of CKD2,16 cases of CKD3,14 cases of CKD4,18 cases of CKD5（none case of hemodialysis）.20 healthy volunteers were enrolled as control.Serum levels of sCD146 were measured by ELISA.Results：The serum levels of sCD146 in each CKD group are,which is significantly higher than those in control group（196.22±30.83）ng/ml.sCD146 levels were gradually increased according to the different stages of CKD（P〈0.05）,meanwhile sCD146 level was positively correlated with Scr,BUN,β2 microglobulin andCystainC（r=0.676,0.680,0.685,0.604,respectively）,andnegatively correlated with eGFR and hemoglobin（r=-0.802,-0.586,respectively）.Stepwised regression analysis showed eGFR and Scr are the independent factors of sCD146 levels.Conclusion：sCD146 is closely correlated with endothelial dysfunction of renal vessel.It may greatly show renal impairment with the progress of CKD.sCD146 also can reflect endothelial dysfunction in early stage.Wheather sCD146 could find renal dysfunction in patients with CKD as a endogenous biomarker requires further study.