HE4在慢性肾脏疾病中的诊断价值

Diagnostic Value of HE4 in Chronic Kidney Disease

目的明确人附睾蛋白4(human epididymis protein 4,HE4)在慢性肾脏疾病不同分期患者中的表达水平,探讨其诊断价值。方法选择2018年1月—2022年9月溧阳市人民医院收治的100例慢性肾脏疾病患者作为观察组,选择同期在本院进行体检的100名健康志愿者作为对照组。利用脲酶法、酶法、胶乳增强免疫比浊法及化学发光微粒子免疫分析法检测血清中尿素氮(BUN)、肌酐(Crea)、胱抑素C(Cys C)、β_(2)微球蛋白(β_(2)-MG)及HE4的含量。对比不同分期慢性肾脏疾病患者与健康体检者之间各项指标的表达差异,并利用受试者工作特征曲线(ROC)评估其诊断价值。结果随着分期的增加,观察组各项指标呈升高趋势,HE4在CKD1期患者血清中的表达与对照组对比,差异有统计学意义(P<0.05);3期、4期、5期的CKD患者与1期患者HE4表达水平相比,差异有统计学意义(P<0.05)。ROC曲线显示HE4对应的曲线下面积最大(AUC=0.920),诊断灵敏度和特异性分别达87.0%和90.0%。结论可通过检测血清HE4辅助慢性肾脏疾病的早期诊断,同时可一定程度反映疾病的进展。

Objective To determine the expression level of human epididymis protein 4(HE4)in patients with different stages of chronic kidney disease,and to explore its diagnostic value.Methods A total of 100 patients with chronic kidney disease admitted to Liyang People's Hospital from January 2018 to September 2022 were selected as the observation group,and 100 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group.The contents of urea nitrogen(BUN),creatinine(Crea),cystatin C(Cys C),β_(2)-microglobulin(β_(2)-MG)and HE4 in serum were detected by urease method,enzymatic method,latex enhanced immunoturbidimetry and chemiluminescence microparticle immunoassay.The expression differences of various indicators between patients with different stages of chronic kidney disease and healthy subjects were compared,and the diagnostic value was evaluated by receiver operating characteristic curve(ROC curve).Results With the increase of stage,the indexes of the observation group showed an increasing trend,and the expression of HE4 in the serum of CKD1 patients compared to the control group,the difference was statistically significant(P<0.05).Compared with stage 1 patients,CKD patients in stages 3,4,and 5 showed higher levels of HE4 expression,the difference was statistically significant(P<0.05).The ROC curve showed that the area under the curve corresponding to HE4 was the largest(AUC=0.920),and the diagnostic sensitivity and specificity were 87.0%and 90.0%,respectively.Conclusion Serum HE4 can assist the early diagnosis of chronic kidney disease and reflect the progress of the disease to a certain extent.