血清分泌型卷曲蛋白5水平与原发性高血压患者早期肾损害的相关性

Correlation between serum secreted frizzled-related protein 5 and early renal damage in patients with essential hypertension

目的分析血清分泌型卷曲蛋白5(secreted frizzled-related protein 5,SFRP5)水平与原发性高血压早期肾损害的相关性。方法选取2017年1-12月就诊于河北医科大学第二医院首次诊断为原发性高血压患者88例和同时期健康体检者32例(A组)。根据尿白蛋白/肌酐比值(urine albumin creatine ratio,UACR)对88例原发性高血压患者进行分组,无早期肾损害者(UACR<30mg/g)41例(B组),存在早期肾损害(30mg/g≤UACR≤300mg/g)者47例(C组)。比较3组SFRP5、胱抑素C(cystatin C,Cys-C)、尿素氮、肌酐水平。结果(1)C组SFRP5水平低于A组、B组(P<0.01),B组SFRP5水平低于A组(P<0.05)。(2)C组Cys-C水平高于A组、B组(P<0.01)。(3)SFRP5与UACR、Cys-C呈负相关(r=-0.839,P<0.01;r=-0.378,P<0.05)。Cys-C与UACR呈正相关(r=0.625,P<0.01)。(4)SFRP5是高血压肾损害的独立保护因子(β=-0.036,P<0.01),Cys-C是高血压肾损害的独立危险因素(β=0.288,P<0.01)。结论SFRP5是高血压患者早期肾损害的保护性因子,有可能成为高血压患者早期肾损害预测和治疗的新靶点之一,为临床用药和评价药物疗效提供新的方向。

Objective To investigate the correlation between serum secreted frizzled-related protein 5(SFRP5)and early renal damage in patients with essential hypertension.Methods During January 2017 to December 2017,a total of 88 patients who were initially diagnosed as essential hypertension in the Second Hospital of Hebei Medical University were recruited,and they were divided into group B(UACR<30 mg/g,n=41)and group C(30 mg/g≤UACR≤300 mg/g,n=47)based on the urine albumin creatine ratio(UACR).During the same period,32 healthy volunteers receiving physical examinations were included in group A.Serum SFRP5,cystatin C(Cys-C),blood urea nitrogen and serum creatinine were compared.Results Serum SFRP5 was significantly lower in group C than that of group A and group B(P<0.01),which was significantly lower in group B than that of group A(P<0.05).Cys-C was significantly higher in group C than that of group A and group B(P<0.01).SFRP5 was negatively correlated with UACR(r=-0.839,P<0.01)and Cys-C(r=-0.378,P<0.05).Cys-C was positively correlated with UACR(r=0.625,P<0.01).SFRP5 was an independent protective factor for hypertensive renal damage(β=-0.036,P<0.01),and Cys-C was an independent risk factor for it(β=0.288,P<0.01).Conclusion SFRP5 may be a protective factor for renal damage in hypertension,serving as a potential predictive and therapeutic target for it.Our findings provide a new direction for clinical medication and evaluation of drug efficacy.