凝血因子Ⅷ、血小板反应蛋白1及可溶性Axl受体酪氨酸激酶在慢性肾小球肾炎患者中的表达情况及诊断价值

Expressions of coagulation factorⅧ,thrombospondin 1,and soluble Axl receptor tyrosine kinase in patients with chronic glomerulonephritis and their diagnostic value

目的分析慢性肾小球肾炎(CGN)患者血浆凝血因子Ⅷ(FⅧ)、血小板反应蛋白1(TSP-1)及可溶性Axl受体酪氨酸激酶(sAxl)水平,并探讨三者对CGN的诊断价值。方法选取63例CGN患者作为研究组,55例健康体检者作为对照组。比较两组研究对象的一般临床资料,以及血浆FⅧ活性、TSP-1水平、sAxl水平。分析CGN患者血浆FⅧ活性、TSP-1水平和sAxl水平与肾功能的相关性。采用受试者工作特征曲线分析FⅧ、TSP-1及sAxl对CGN的诊断价值。结果与对照组相比,研究组患者的24 h尿蛋白水平、血尿素氮水平、血肌酐水平、血尿酸水平、血浆FⅧ活性、血浆TSP-1水平、sAxl水平均升高,肾小球滤过率(GFR)降低(均P<0.05)。CGN患者血浆FⅧ活性及TSP-1、sAxl水平与血尿素氮水平、血肌酐水平、血尿酸水平均呈正相关,与GFR均呈负相关(均P<0.05)。血浆FⅧ活性、TSP-1水平、sAxl水平单独检测及联合检测诊断CGN的灵敏度分别为87.30%、77.78%、85.71%、84.13%,特异度分别为56.36%、50.91%、58.18%、61.82%,曲线下面积分别为0.724、0.719、0.702、0.793。结论CGN患者血浆FⅧ活性及TSP-1、sAxl水平明显升高,且与肾功能具有一定相关性,三者联合检测对CGN具有较高的诊断价值。

Objective To analyze the levels of plasma coagulation factorⅧ(FⅧ),thrombospondin 1(TSP-1)and soluble Axl receptor tyrosine kinase(sAxl)in patients with chronic glomerulonephritis(CGN),and to explore the diagnostic value of the three on CGN.Methods A total of 63 CGN patients were selected as study group,and 55 healthy check-up people as control group.The basic clinical data,plasma FⅧactivity,TSP-1 level,and sAxl level were compared between the two groups.The correlation of plasma FⅧactivity,TSP-1 and sAxl levels with renal function was analyzed in CGN patients.The receiver operating characteristic curve was used to analyze the diagnostic value of FⅧ,TSP-1,and sAxl on CGN.Results Compared with the control group,the levels of 24 hours urine protein,blood urea nitrogen,serum creatinine,and blood uric acid,as well as plasma FⅧactivity,TSP-1 level and sAxl level in the study group were elevated,and glomerular filtration rate(GFR)was decreased in the study group(all P<0.05).Plasma FⅧactivity,TSP-1 and sAxl levels of CGN patients positively correlated with blood urea nitrogen,serum creatinine,and blood uric acid levels of CGN patients,and negatively correlated with GFR of CGN patients(all P<0.05).The sensitivities of plasma FⅧactivity,TSP-1 and sAxl levels for alone and jointly detecting the diagnosis on CGN were 87.30%,77.78%,85.71%,and 84.13%,respectively,the specificities were 56.36%,50.91%,58.18%,and 61.82%,respectively,and the areas under the curve were 0.724,0.719,0.702,and 0.793,respectively.Conclusion Plasma FⅧactivity,TSP-1 and sAxl levels are significantly elevated in CGN patients,and have correlations with renal function to a certain extent.The combined detection of the three exerts a relatively high diagnostic value on CGN.