慢性肾脏病患者治疗前后血清miR-30a-5p和miR-196a水平变化及价值

Dynamic changes and clinical value of serum miR-30a-5p and miR-196a-5p levels before and after therapy in patients with chronic kidney disease

目的检测并分析慢性肾脏病(chronic kidney disease,CKD)患者治疗前、连续治疗不同随访时间点血清miR-30a-5p和miR-196a-5p水平动态变化,探讨其作为CKD患者辅助诊断及疗效监测分子标志物的价值。方法收集江苏省中医院肾内科2015年4月至2016年2月就诊的20例CKD患者治疗前以及连续治疗并随访3~6个月的血清标本,记录患者血生化及尿液指标,同时收集23例体检健康者血清标本作为对照。采用实时荧光定量PCR检测各组血清miR-30a-5p和miR-196a-5p水平。采用非参数检验、Spearman秩相关分析血清miR-30a-5p和miR-196a-5p的水平变化及临床应用价值。结果与健康人对照相比,CKD患者治疗前血清miR-30a-5p[0.563(0.324,1.737)vs 0.270(0.127,0.435),U=100.5,P=0.004]和miR-196a-5p[0.423(0.154,1.270)vs 0.121(0.056,0.168),U=74,P=0.0003]水平显著升高。与CKD患者治疗前相比,CKD患者血清miR-30a-5p和miR-196a-5p水平从治疗后第3个月开始呈持续降低趋势,至第6个月,其miR-30a-5p[0.344(0.128,0.672)vs 0.563(0.324,1.737),P=0.020],miR-196a-5p[0.227(0.079,0.474)vs 0.423(0.154,1.270),P=0.030]水平与治疗前比较差异有统计学意义。Spearman相关性分析显示,血清miR-30a-5p和miR-196a-5p水平与估算的肾小球滤过率(eGFR)呈显著负相关(r=-0.223,P=0.013;r=-0.191,P=0.035)。结论CKD患者血清miR-30a-5p和miR-196a-5p水平检测有助于反映肾脏功能,具备成为CKD患者辅助诊断及疗效监测分子标志物的潜能。

Objective To detect and analyze the dynamic changes of serum miR-30a-5p and miR-196a-5p levels at different time points before and after therapy in patients with chronic kidney disease(CKD),and explore their clinical values as molecular markers in the aided diagnosis and efficacy monitoring of CKD.Methods Twenty CKD patients admitted at the Department of Nephrology,Jiangsu Province Hospital of Chinese Medicine between April 2015 and February 2016 were enrolled in our study.Their serum samples before therapy and at different follow-up visits 3~6 months after treatment were collected.Meanwhile,serum samples from 23 age-and sex-matched healthy subjects were collected as normal controls.The levels of serum miR-30a-5p and miR-196a-5p were determined by the quantitive real-time PCR assay.The biochemical parameters and urinary indices of CKD patients were also recorded.The changes and clinical values of serum miR-30a-5p and miR-196a-5p levels were evaluated by the nonparametric test and Spearman's rank correlation analysis.Results The levels of serum miR-30a-5p[0.563(0.324,1.737)vs 0.270(0.127,0.435),U=100.5,P=0.004]and miR-196a-5p[0.423(0.154,1.270)vs 0.121(0.056,0.168),U=74,P=0.0003]in CKD patients before treatment were significantly higher than those in healthy controls.Compared with before treatment,the levels of serum miR-30a-5p and miR-196a-5p in CKD patients showed a continuous decreasing trend from the third month after treatment.The levels of serum miR-30a-5p[0.344(0.128,0.672)vs 0.563(0.324,1.737),P=0.020]and miR-196a-5p[0.227(0.079,0.474)vs 0.423(0.154,1.270),P=0.030]at the sixth month after treatment were significantly lower than those before treatment.Spearman correlation analysis showed that serum miR-30a-5p and miR-196a-5p levels in CKD patients were significantly negatively correlated with estimated glomerular filtration rate(eGFR;r=-0.223,P=0.013;r=-0.191,P=0.035).Conclusion The levels of serum miR-30a-5p and miR-196a-5p in CKD patients may reflect renal function,and have the potential as molecular markers for the aided diagnosis and efficacy monitoring of CKD.