血清PODXL监测子痫前期早期肾脏损伤的初步研究

Primary study of serum PODXL in monitoring early renal injury in preeclampsia

目的:探讨血清足细胞标志蛋白足糖萼蛋白(PODXL)在子痫前期早期肾脏损伤和修复中的意义。方法:收集2018年3月至2019年9月于西安交通大学第一附属医院门诊就诊的子痫前期患者54例为病例组(尿蛋白阴性12例,阳性42例;应用硫酸镁9例,未用45例),同期无并发症正常分娩的孕妇39例为对照组。分别于分娩前、产后2天、产后5天和7天测PODXL,比较两组产前及产后血清中PODXL的变化,分析血清中PODXL与尿蛋白的关系以及应用硫酸镁对其浓度的影响。结果:病例组产前PODXL浓度[(11.15±3.38)ng/ml]明显低于对照组[(16.22±4.87)ng/ml](P=0.000);产后PODXL浓度逐渐升高,至产后7天恢复正常。与对照组相比,尿蛋白阴性组产前PODXL[(13.78±1.89)ng/ml]显著降低(P=0.014);尿蛋白阳性组PODXL[(10.40±3.35)ng/ml]显著低于尿蛋白阴性组(P=0.000)。硫酸镁组产后2天血清PODXL[(14.35±1.60)ng/ml]明显高于未用硫酸镁组(P=0.001),且与对照组无统计学差异(P=0.345)。结论:血清PODXL可早于尿蛋白反映子痫前期早期肾脏损伤,产前应用硫酸镁可能利于肾脏足细胞功能的修复。

Objective:To investigate the significance of podocalyxin(PODXL)in the early renal injury of preeclampsia.Methods:54 cases of preeclampsia were collected from March 2018 to September 2019 in the outpatient department of the First Affiliated Hospital of Xi'an Jiaotong University as the case group,and 39 cases of pregnant women without complications as the control group.Serum PODXL was tested before delivery,2 days after delivery,5 days and 7 days after delivery.The changes of serum PODXL in the two groups before and after delivery were compared,and the relationship between serum PODXL and urine protein was analyzed,as well as the effect of magnesium sulfate on its concentration.Result:The concentration of PODXL in the case group before delivery[(11.15±3.38)ng/ml]was significantly lower than that in the control group[(16.22±4.87)ng/ml](P=0.000),while after delivery it gradually increased,and returned to normal 7 days postpartum.The concentration of PODXL[(13.78±1.89)ng/ml]in the urinary protein negative group was lower than that in the control group statistically(P=0.014).The concentration of PODXL in the urinary positive group[(10.40±3.35)ng/ml]was significantly lower than that in the urinary protein negative group(P<0.01).The serum PODXL concentration of magnesium sulfate group[(14.35±1.60)ng/ml]was significantly higher than that of no magnesium sulfate group(P=0.001),and there was no significant difference with control group(P=0.345).Conclusions:Serum PODXL can reflect the renal damage earlier than urinary protein,which is expected to be an effective indicator of early renal damage and repair in preeclampsia.Application of magnesium sulfate may be beneficial in repairing of renal podocyte function.