肾小管功能标志物与慢性肾病患者发生心血管疾病风险的相关性分析

Correlation analysis of renal tubular function markers and the risk of cardiovascular disease in patients with chronic kidney disease

目的探讨肾小管功能标志物与慢性肾病(CKD)患者发生心血管疾病(CVD)风险的相关性以及其在早期预测CKD患者CVD中的应用价值.方法选取2018年1月至2019年1月本院收治的200例CKD患者为研究对象,其中发生CVD的103例患者为CVD组,未出现CVD的97例患者为对照组.测定所有患者的肾小管功能标志物,包括α-1微球蛋白(α-1m)、β-2微球蛋白(β-2m)和尿调节蛋白水平,并记录所有患者临床参数.比较两组患者的人口学资料、肾功能指标、α-1m、β-2m、尿调节蛋白水平等,采用Pearson线性方程分析肾小管功能标志物与CKD患者CVD发生风险的相关性;绘制受试者工作特征(ROC)曲线分析肾小管功能标志物在早期预测CKD患者CVD的应用价值.结果CVD组患者的α-1m、β-2m水平高于对照组,尿调节蛋白水平低于对照组,差异均有统计学意义(均P<0.001).Pearson相关分析结果显示,α-1m、β-2m与CKD患者与CVD发生风险呈正相关(P<0.001),尿调节蛋白与CKD患者CVD发生风险呈负相关(P<0.001).α-1m、β-2m、尿调节蛋白预测CKD患者发生CVD风险的曲线下面积分别为0.863、0.809、0.770,灵敏度分别为77.32%、92.78%、81.44%,特异度分别为79.61%、62.11%、66.02%.结论CKD患者的肾小管功能标志物与发生CVD风险具有显著相关性,预测价值高,其可作为CKD患者发生CVD风险的预测指标,可指导临床防治CKD患者CVD的发生.

Objective To explore the correlation between renal tubular function markers and the risk of cardiovascular disease(CVD)in patients with chronic kidney disease(CKD)and the application value of early prediction of CVD in CKD patients.Methods A total of 200 patients with CKD admitted to our hospital from January 2018 to January 2019 were selected as the study subjects,including 103 patients with CVD in the CVD group and 97 patients without CVD in the control group.Renal tubule function markers:α-1 microglobulin(α-1m),β-2 microglobulin(β-2m)and urinary regulatory protein levels were measured in all patients,and clinical parameters of all patients were recorded.Demographic data,renal function indexes,α-1m,p-2m,urinary regulatory protein levels,etc.,were compared between the two groups.Pearson linear equation was used to analyze the correlation between renal tubular function markers and the risk of CVD in patients with CKD.Receiver operating characteristic(ROC)curve was drawn to analyze the application value of renal tubular function markers in early prediction of CVD in patients with CKD.Results The levels of α-1m and β-2m in CVD group were higher than those in control group,and the levels of urinary regulatory protein were lower than those in control group,the differences were statistically significant(all P<0.001).Pearson's correlation analysis showed that α-1m and β-2m were positively correlated with the risk of CVD in patients with CKD(P<0.001),while urinary regulatory protein was weakly negatively correlated with the risk of CVD in patients with CKD(P<0.001).The AUC of α-1m,β-2m and urinary regulatory protein in predicting the risk of CVD in Patients with CKD were 0.863,0.809 and 0.770,with sensitivity of 77.32%,92.78%and 81.44%,and specificity of 79.61%,62.11%and 66.02%,respectively.Conclusions Renal tubular function markers in Patients with CKD are significantly correlated with the risk of CVD and have high predictive value,which can be used as a predictor of the risk of CVD in patients with CKD and can guide the clinical prevention and treatment of CVD in patients with CKD.