HIF—1α、CysC、β2-MG水平在COPD患者早期肾损伤中的表达及其意义

Correlation Analysis of Early Renal Injury with HIF-1α, Cys C, and β2-MG Levels in COPD Patients

【目的】探讨血清低氧诱导因子-1α（H1F—1α）、胱押素C（Cysc）、β2微球蛋白（β2-MG）水平在老年慢性阻塞性肺疾病（COPD）患者早期肾损伤中的表达及临床意义。【方法】选择2012年1月至2016年1月本院收治的老年COPD患者95倒（COPD组），依据氧分压（Pa02）分为轻、中、重度缺氧（A1、A2、A3）三组，依据肺动脉收缩压分为无肺动脉高压及有肺动脉高压（B1、B2）两组，另选取医院同期体检健康者30例为对照纽，EI。IsA法检测血清HIF-1α、CysC、G2-MG水平，全自动生化分析仪检测肾功能指标肌酐（SCr）、尿素氮（BUN）及视黄醇结合蛋白（RBP），估算肾小球滤过率（eGFR）并比较分析各指标变化。【结果】COPD组血清HIF-1α、CysC、B2MG水平明显高于对照组（P〈0．05），eGFR低于对照组（P〈0．0,5），但两组SCr、BUN、RBP水平比较差异无统计学意义（P〉0．05）；HIF-1α、CysC、82-MG水平比较，对照组〈A1组〈A2组〈A3组（P〈0．05），A2、A3组eGFR低于对照组（P〈0．05），A1组eGFR与对照组比较差异无统计学意义（P〉0．05）；HIF-1α、CysC、β2-MG水平比较，对照纽〈B1≮B2组（P〈0．05），B2组eGFR低于对照组（P〈0．05）；HIF1d、B2MG与CysC均呈正相关（r=0．563，r=0．425，P〈0．05），HIF-1α、CysC、B2-MG与eGFR呈负相关（r=-0．611，r=-0．569，r=-0．482，P〈0．05）。【结论】COPD慢性缺氧可引起早期肾功能损伤，血清H1F一1Ot、CysC、B2MG水平监测可用于评估COPD患者早期肾损伤，而联合检测可能对于COPD患者早期肾损伤评估有重要意义。

[Objective]The aim was to investigate the correlation among serum factors such as hypoxia-inducible factor- la （HIF-la）, cystatin C （Cys C） and β2-microglobulin （β2-MG） with early renal injury in elderly patients with chronic obstructive pulmonary disease （COPD）. [Methods]A total of 95 elderly patients with COPD in our hospital from January 2012 to January 2016 were enrolled. They were divided into three groups： mild, moderate and severe hypoxia （A1, A2, and A3） according to oxygen partial pressure （PaO2）. Based on pulmonary artery systolic pressure, patients were split into two groups B1 （without pulmonary hypertension） and B2 （pulmonary hypertension） . Thirty cases of healthy persons in the same period were selected as tile control group. HIF-1a, Cys C, and β2-MG levels in serum were detected by ELISA. The renal function index （SCr, BUN,RBP and eGFR） were measured as well. The changes of the indexes were compared and analyzed. [Results]The levels of HIF-la, Cys C and 132-MG in serum were higher in COPD group than that in healthy con- trol group （ P〈0.05） ; eGFR was lower than that of the control group （ P〈0.05）. SCr, BUN and RBP had no significant difference between COPD group and control group. The levels of HIF-la, Cys C and 132-MG in the control group were sig- nificantly lower than those in the A1 group, while those in the A1 group were lower than those in the A2 group （ P〈0.05） and those in the A2 group were lower than those in the A3 group. The eGFR in the A2 and A3 groups were lower than that in the control group （ P %0.05）. There was no significant difference in eGFR between the A1 group and the control group （ P〉0.05）. The levels of HIF-la, Cys C and ]32-MG were in order of control group 〈 group Bi〈 group B2 （ P 〈0.05）, and eGFR in the B2 group was lower than in the control group （ P〈0.05）. HIF-1α, β2-MG and Cys C were positively cor- related （ r = 0.563,r = 0.425, P =0.05）, HIF-1α, Cys C, 132-MG and eGFR were negatively correlated （ r = -0.611, r = -0.569, r = -0.482,P 〈0.05）. [Conclusion]The results show that chronic hypoxia in COPD can cause early renal in jury. Monitoring HIF-1α, Cys C and J32-MG levels in serum can be used to evaluate early renal injury in COPD patients. Combined detection may be important for early renal injury assessment in COPD patients.