探讨肾功能衰竭患者血清VE-Cad、Ang-2及尿KIM-1表达情况及与病情严重程度的相关性

To Investigate the Expression of Serum VE-Cad,Ang-2 and Urinary KIM-1 and Its Correlation with Disease Severity in Patients with Renal Failure

目的:探讨肾功能衰竭患者血清血管内皮钙黏蛋白(VE-Cad)、血管生成素2(Ang-2)及尿肾损伤分子1(KIM-1)表达情况及与病情严重程度的相关性。方法:选取我院2018年2月到2021年2月收治的76例慢性肾功能衰竭患者作为研究对象,依照其病情严重程度进行分组,分为肾功能代偿组(n=25),氮质血症组(n=18),肾功能衰竭组(n=21)和尿毒症组(n=12),对比四组患者VE-Cad、Ang-2、KIM-1表达情况,并分析VE-Cad、Ang-2、KIM-1与慢性肾功能衰竭病情严重程度的相关性。对所有患者进行电话随访或复查随访,将76例慢性肾功能衰竭患者依照预后情况分为两个亚组,存活组(n=56)和死亡组(n=20),对比两组患者临床情况和各指标水平,并应用Logistic回归分析分析VE-Cad、Ang-2、KIM-1对慢性肾功能衰竭预后预测价值。结果:四组患者VE-Cad、Ang-2、KIM-1表达水平差异显著,尿毒症组明显高于肾功能衰竭组、氮质血症组和肾功能代偿组(P<0.05);Spearman相关分析结果显示:VE-Cad、Ang-2、KIM-1与慢性肾功能衰竭病情严重程度呈正相关(P<0.05);存活组与死亡组患者性别、年龄、BMI、器官衰竭≥2个、少尿、VE-Cad水平对比无差异(P>0.05),存活组与死亡组患者APACHEⅡ评分、CysC、Ang-2、KIM-1水平对比差异显著(P<0.05);logistic回归分析结果表明,APACHEⅡ评分、CysC、KIM-1为影响慢性肾功能衰竭预后的独立危险因素(P<0.05)。结论:VE-Cad、Ang-2、KIM-1与慢性肾衰竭患者病情严重程度呈正相关,临床可以考虑参考三者水平来评价慢性肾衰竭患者的病情严重程度。而三者中仅有KIM-1与肾功能衰竭患者的预后情况具有一定关系,因此临床可以考虑在APACHEⅡ评分与CysC预测预后的基础上增加KIM-1指标进行判断,进而提升预后预测准确性。

Objective:To investigate the expression of serum vascular endothelial cadherin(VE CAD),angiopoietin-2(Ang-2)and urinary renal injury molecule-1(KIM-1)in patients with renal failure and their correlation with the severity of the disease.Methods:76 patients with chronic renal failure treated in our hospital from February 2018 to February 2021 were selected as the research objects.They were divided into renal function compensation group(n=25),azotemia group(n=18),renal failure group(n=21)and uremia group(n=12)according to the severity of their condition.The expressions of ve-cad,Ang-2 and KIM-1 in the four groups were compared and analyzed Correlation between KIM-1 and the severity of chronic renal failure.All patients were followed up by telephone or reexamination.76 patients with chronic renal failure were divided into two subgroups according to the prognosis,survival group(n=56)and death group(n=20).The clinical conditions and index levels of the two groups were compared,and the predictive value of ve-cad,Ang-2 and KIM-1 on the prognosis of chronic renal failure was analyzed by logistic regression analysis.Results:The expression levels of ve-cad,Ang-2 and KIM-1 in uremia group were significantly higher than those in renal failure group,azotemia group and renal function compensation group(P<0.05);Spearman correlation analysis showed that VE CAD,Ang-2 and KIM-1 were positively correlated with the severity of chronic renal failure(P<0.05);There was no significant difference in gender,age,BMI,organ failure≥2,oliguria and ve CAD between the survival group and the death group(P>0.05).There was significant difference in ApacheⅡscore,CysC,Ang-2 and KIM-1 between the survival group and the death group(P<0.05);Logistic regression analysis showed that ApacheⅡscore,CysC and KIM-1 were independent risk factors affecting the prognosis of chronic renal failure(P<0.05).Conclusion:Ve-cad,Ang-2 and KIM-1 are positively correlated with the severity of patients with chronic renal failure.It can be considered to evaluate the severity of patients with chronic renal failure by referring to the levels of the three.Among the three,only KIM-1 has a certain relationship with the prognosis of patients with renal failure.Therefore,it can be considered to add KIM-1 index to judge on the basis of ApacheⅡscore and CysC prediction of prognosis,so as to improve the accuracy of prognosis prediction.