尿液血管紧张素原与慢性肾脏病的关联

Significance of urine angiotensinogen in patients with chronic kidney disease

目的:探讨尿液血管紧张素原(angiotensinogen,AGT)与慢性肾脏病(CKD)的关联性,以及尿AGT对CKD的诊断价值。方法:从新疆维吾尔自治区墨玉县农村维吾尔族成人CKD流行病学调查的资源标本库中抽取CKD和非CKD样本,按估算的肾小球滤过率(eGFR)将CKD患者分为CKD 1期组、CKD 2期组、CKD 3期组。尿AGT用ELISA方法检测。one-way-ANOVA分析组间差异,多因素分析采用多重线性回归分析。结果:95例CKD患者和413例非CKD对照者进入本研究。CKD组尿液AGT明显高于非CKD组(243.97±47.86 vs 158.43±25.14,t=16.892,P<0.01);随着eGFR下降,尿液中AGT呈升高趋势,CKD 1期组、CKD 2期组和CKD 3期组患者尿液AGT分别为213.63±34.47 ng/L,251.39±17.17 ng/L和314.97±27.58 ng/L,各组间有显著差异(F=81.103,P<0.01)。多重线性回归分析表明,尿液AGT与eGFR呈负相关(P<0.01),与尿白蛋白/肌酐(P<0.01)和血清肌酐(P<0.01)呈正相关。结论:CKD患者尿AGT高于非CKD患者,与eGFR下降呈负相关。提示尿AGT可作为CKD诊断和病程进展的生物学标志物。

Objective： To analyze the concentration of urine angiotensinogen（ AGT） in patients with chronic kidney disease（ CKD）,and to explore the significance of urinary AGT excretion in the diagnosis of CKD. Methodology：Clinical data of CKD and non CKD patients from the CKD resource repository in a cross-sectional survey were collected.CKD patients were divided into 3 groups according to estimated glomerular filtration rate（ eGFR） ： CKD 1 group,CKD 2 group and CKD 3 group. Urine AGT was detection by ELISA method. Results： A total of 95 CKD patients and 413 non CKD controls were enrolled in this study. Urine AGT in CKD group was significantly higher than that in non CKD group（ 243. 9±47. 9 vs 158. 4±25. 14,P0. 01）,With the decrease of eGFR,urine AGT level increased,it was 213. 6±34. 5 ng/L,251. 4± 17. 2 ng/L and 314. 9 ± 27. 6 ng/L in CKD 1 group,CKD 2 group and CKD 3 group respectively（ F =81. 103,P0. 01）. Multiple linear regression analysis showed that urine AGT was negatively correlated with eGFR（ p〈0. 01） and positively correlated with urine albumin/creatinine（ P0. 01） and serum creatinine（ P0. 01）. Conclusion：Urinary AGT excretion was significantly elevated in CKD patients,and it was negatively correlated with eGFR. Urine AGT may be a useful biomarker of CKD.