慢性肾脏病患者血清HE4与CA125的变化及临床意义

The changes and clinical significance of HE4 and CA125 in patients with chronic kidney disease

目的探讨慢性肾脏病（CKD）患者不同时期血清人附睾蛋白4（HE4）和糖类抗原125（CA125）水平的变化及临床意义。方法选取各期CKD（CKD 1-5）患者共66例,健康体检者（健康对照组）40例。分别采用电化学发光法检测各组血清HE4、CA125水平,同时用肌氨酸氧化酶法测定患者血清肌酐（SCr）,散射比浊法检测患者尿微量清蛋白（mALB）、α1-微球蛋白（α1-MG）水平,用MDRD简化方程计算肾小球滤过率估算值（eGFR）。结果血清HE4在CKD各阶段均高于健康对照组,差异有统计学意义（P〈0.05）,且各阶段患者血清间HE4差异均有统计学意义（P〈0.05）;与患者eGFR呈负相关（r=-0.532,P〈0.05）,与患者尿α1-MG呈正相关（r=0.279,P=0.048）。血清CA125水平在CKD1阶段没有明显增高（P=0.06）,但在CKD2-5阶段明显增高,差异有统计学意义（P〈0.05）。但各阶段患者血清CA125间差异均无统计学意义（P〉0.05）;患者血清CA125与eGFR、尿mALB、α1-MG均无明显相关性（P〉0.05）。结论血清HE4水平变化与CKD的发生发展有关,对判断CKD的分期有重要的意义,可能作为判断CKD严重程度的重要指标。

Objective To investigate the changes and clinical significance of serum concentrations of epididymis protein 4（HE4）and carbohydrate antigen 125（CA125）in different stages of chronic kidney disease（CKD）.Methods A total of 66 CKD patients at different stages（CKD 1-5）and 40 healthy volunteers（health control group）with normal renal and ovarian function were enrolled.The determinations of serum HE4,CA125 were analysed by electrochemiluminescence,and serum creatinine（SCr）was analysed by sarcosine oxidase method,urinary microalbumin（mALB）andα1microglobulin（α1-MG）were analysed by scattering immunoturbidimetric assay.Estimated glomerular filtration rate（eGFR）was calculated by the simplified MDRD formula.Results Significantly increased of HE4 concentrations were found in individuals in different stages of CKD compared with health control group（P〈0.05）.There were significant increase in serum HE4 among different stages compared with each other（P〈0.05）.Significantly negatively correlation was found between serum HE4 and eGFR（r=-0.532,P〈0.05）,while significantly positively correlation was found between serum HE4 and urinaryα1-MG（r=0.279,P=0.048）.There was no significant increase in serum CA125 in the stage of CKD1（P=0.06）,while significantly increased CA125 concentrations were found in individuals in different stages of CKD2-5compared with clinical controls（P〈0.05）.However,there was no significant increase in serum CA 125 among different stages compared with each other（P〈0.05）.And there was also no significant correlation between serum CA125 and eGFR,α1-MG and mALB（P〈0.05）.Conclusion The change of serum HE4 level is related to the occurrence and development of CKD,further morer,it is closely associated with the severity of CKD,may be it′s an important index for judging the stages of CKD.