高血压肾病患者血清PEPT1和PEPT2表达与肾功能减退及预后的相关性分析

Correlation analysis of serum PEPT1 and PEPT2 expression with renal dysfunction and prognosis in patients with hypertensive nephropathy

目的探讨高血压肾病患者血清肠肽转运蛋白1(PEPT1)和肠肽转运蛋白2(PEPT2)表达与肾功能减退及预后的相关性。方法选取2010年1月至2020年1月该院肾内科收治的192例高血压肾病患者作为高血压肾病组。另随机选择同期于该院门诊体检的63例健康志愿者为对照组。采用实时定量聚合链反应检测PEPT1、PEPT2相对表达水平,全自动生化分析仪检测血尿素氮(BUN)、血肌酐(Scr),计算估算的肾小球滤过率(eGFR)。分析PEPT1、PEPT2与BUN、Scr、eGFR的相关性,影响高血压肾病进展为终末期肾病(ESRD)的因素,绘制受试者工作特征曲线,分析PEPT1、PEPT2预测高血压肾病进展为ESRD的价值。结果高血压肾病组血清PEPT1、PEPT2相对表达水平和eGFR低于对照组,BUN、SCr水平高于对照组,差异均有统计学意义(P<0.05)。高血压肾病患者血清PEPT1、PEPT2与BUN、SCr呈负相关(P<0.05),与eGFR呈正相关(P<0.05)。ESRD组年龄、收缩压、舒张压、高血压肾病病程、BUN、SCr高于NESRD组,血清PEPT1、PEPT2、eGFR低于NESRD组,差异有统计学意义(P<0.05)。收缩压、高血压肾病病程是高血压肾病进展为ESRD的危险因素(P<0.05),PEPT1、PEPT2、eGFR是保护因素(P<0.05)。PEPT1、PEPT2及联合预测高血压肾病进展为ESRD的曲线下面积为0.636、0.714、0.897。结论高血压肾病患者血清PEPT1、PEPT2相对表达水平增高,且与肾功能减退及ESRD进展有关,可作为预后预测的标志物。

Objective To investigate the correlation between serum peptide transporter 1(PEPT1)and peptide transporter 2(PEPT2)expression with renal dysfunction and prognosis in patients with hypertensive nephropathy.Methods 192 patients with hypertensive nephropathy admitted to the Department of Nephrology in a hospital from January 2010 to January 2020 were selected as the hypertensive nephropathy group.In addition,63 healthy volunteers who underwent physical examination in the same period were randomly selected as the control group.The expression of PEPT1 and PEPT2 was detected by real-time quantitative polymeric chain reaction.The blood urea nitrogen(BUN)and serum creatinine(Scr)were detected by automatic biochemical analyzer,and the estimated glomerular filtration rate(eGFR)was calculated.The correlation between PEPT1 and PEPT2 with BUN,Scr,eGFR,and factors affecting the progression of hypertensive nephropathy to end-stage renal disease(ESRD)were analyzed.The receiver operating characteristic curve was drawn to analyze the value of PEPT1 and PEPT2 in predicting the progression of hypertensive nephropathy to ESRD.Results The relative expression levels of PEPT1,PEPT2 and eGFR in hypertensive nephropathy group were lower than those in control group,and BUN and SCr levels were higher than those in control group,the differences were statistically significant(P<0.05).Serum PEPT1 and PEPT2 were negatively correlated with BUN and SCr(P<0.05),but positively correlated with eGFR(P<0.05).Age,systolic blood pressure,diastolic blood pressure,duration of hypertensive nephropathy,BUN and SCr in ESRD group were higher than those in NESRD group,while serum PEPT1,PEPT2 and eGFR in ESRD group were lower than those in NESRD group,with statistical significance(P<0.05).Systolic blood pressure and duration of hypertensive nephropathy were risk factors for progression to ESRD(P<0.05),PEPT1,PEPT2 and eGFR were protective factors(P<0.05).The area under the curve of PEPT1,PEPT2 and combined predicted the progression to ESRD were 0.636,0.714 and 0.897.Conclusion The relative expression levels of PEPT1 and PEPT2 in serum are increased in patients with hypertensive nephropathy,which is related to renal dysfunction and ESRD progression,and can be used as prognostic markers.