E-钙黏附蛋白、骨膜蛋白在高血压肾病中的诊断价值

Diagnostic value of E-cadherin and periostin in hypertensive nephropathy

目的探讨E-钙黏附蛋白、骨膜蛋白在高血压肾病中的诊断价值。方法选取2017年1月至2019年1月该院收治的108例高血压患者为研究对象,依据患者的严重程度分成单纯高血压组(35例)、高血压肾病Ⅰ~Ⅱ期组(40例)、高血压肾病Ⅲ~Ⅳ期组(33例),选择同期参加体检的35例健康志愿者纳入对照组,采用酶联免疫吸附试验(ELISA)法检测血清中E-钙黏附蛋白、骨膜蛋白水平。并对各项指标进行相关分析和Logistic回归分析。结果与对照组比较,单纯高血压组、高血压肾病Ⅰ~Ⅱ期组、高血压肾病Ⅲ~Ⅳ期组E-钙黏附蛋白水平明显降低,骨膜蛋白水平明显增加,差异有统计学意义(P<0.05);与单纯高血压组比较,高血压肾病Ⅰ~Ⅱ期组、高血压肾病Ⅲ~Ⅳ期组E-钙黏附蛋白水平明显降低,骨膜蛋白水平明显增加,差异有统计学意义(P<0.05);与高血压肾病Ⅰ~Ⅱ期组比较,高血压肾病Ⅲ~Ⅳ期组E-钙黏附蛋白水平明显降低,骨膜蛋白水平明显增加,差异有统计学意义(P<0.05)。相关性分析显示,E-钙黏附蛋白与24h尿清蛋白排泄率(UAER,r=-0.487,P=0.012)、尿素氮(r=-0.312,P=0.021)、血清肌酐(r=-0.341,P=0.043)呈负相关,与肾小球滤过率(r=0.512,P=0.017)呈正相关。骨膜蛋白与UAER(r=0.412,P=0.033)、尿素氮(r=0.447,P=0.029)、血清肌酐(r=0.337,P=0.036)呈正相关,与肾小球滤过率(r=-0.486,P=0.028)呈负相关。而E-钙黏附蛋白与骨膜蛋白呈负相关(r=-0.509,P=0.015)。多因素回归分析显示E-钙黏附蛋白、骨膜蛋白是影响高血压肾病的独立危险因素(P<0.05)。结论 E-钙黏附蛋白、骨膜蛋白水平可以作为诊断高血压肾病的标志物。

Objective To investigate the diagnostic value of E-cadherin and periostin in hypertensive nephropathy.Methods A total of 108 patients with hypertension were divided into three groups according to the severity of the patients,including simple hypertension group(35 cases),hypertensive nephropathyⅠ-Ⅱstage group(40 cases),hypertensive nephropathy Ⅲ-Ⅳ stage group(33 cases),and 35 healthy volunteers who participated in the physical examination at the same time were recruited into control group.Serum E-cadherin and periostin levels were measured by ELISA.Correlation linear analysis and Logistic regression analysis were done.Results Compared with the control group,E-cadherin levels decreased significantly and periostin levels increased significantly in the simple hypertensive group,hypertensive nephropathyⅠ-Ⅱstage group and hypertensive nephropathyⅢ-Ⅳstage group(P<0.05).Compared with the simple hypertension group,the level of E-cadherin in the hypertensive nephropathyⅠ-Ⅱstage group,hypertensive nephropathy Ⅲ-Ⅳstage group decreased significantly,and the periostin protein level increased significantly(P<0.05).Compared with the hypertensive nephropathyⅠ-Ⅱstage group,the level of E-cadherin decreased significantly in the hypertensive nephropathyⅢ-Ⅳstage group,and the level of periostin increased significantly(P<0.05).Correlation analysis showed that E-cadherin correlated negatively with UAER(r=-0.487,P=0.012),urea(r=-0.312,P=0.021),serum creatinine(r=-0.341,P=0.043),and glomerular filtration rate(r=0.512,P=0.017)correlated positively.Periostin correlated positively with UAER(r=0.412,P=0.033),urea(r=0.447,P=0.029),serum creatinine(r=0.337,P =0.036),and negatively correlated with glomerular filtration rate(r=-0.486,P=0.028).E-cadherin correlated with periostin(r=-0.509,P=0.015).Multivariate regression analysis showed that E-cadherin and periostin were independent risk factors for hypertensive nephropathy(P<0.05).Conclusion E-cadherin and periostin levels could be used as markers for hypertensive renal injury.