血清Visfatin联合尿CTGF对H型高血压患者肾损伤的预测价值

Predictive value of serum Visfatin combined with urinary CTGF for renal injury in patients with H-type hypertension

目的探讨血清内脂素(Visfatin)联合尿结缔组织生长因子(CTGF)对H型高血压患者肾损伤的预测价值。方法选取2021年10月至2022年10月该院收治的120例H型高血压患者作为研究组,另外选取132例同期来该院体检的健康者作为对照组。根据是否发生肾损伤将H型高血压患者进一步分为非损伤组(n=74)和损伤组(n=46)。采用酶联免疫吸附试验检测血清Visfatin和尿CTGF表达水平,采用受试者工作特征(ROC)曲线评估血清Visfatin和尿CTGF对H型高血压患者肾损伤的预测价值,采用多因素Logistic回归分析H型高血压患者肾损伤的影响因素。结果研究组血清Visfatin与尿CTGF水平明显高于对照组(P<0.05);损伤组血清Visfatin与尿CTGF水平明显高于非损伤组(P<0.05)。血清Visfatin与尿CTGF预测H型高血压患者肾损伤的ROC曲线下面积(AUC)为0.811(95%CI:0.766~0.864)、0.786(95%CI:0.743~0.829);血清Visfatin与尿CTGF联合预测的AUC为0.915(95%CI:0.879~0.957),灵敏度为87.38%,特异度为84.42%。损伤组患者白蛋白、肾小球滤过率明显低于非损伤组(P<0.05),损伤组患者尿蛋白量、尿素氮、血肌酐、血尿酸水平明显高于非损伤组(P<0.05)。多因素Logistic回归分析结果显示,血肌酐>103.53μmol/L(OR=2.257,95%CI:1.241~4.103)、肾小球滤过率≤92.28 mL/(min·1.73 m^(2))(OR=2.633,95%CI:1.412~4.910)、Visfatin≥9.18μg/L(OR=3.959,95%CI:1.854~8.453)、CTGF≥30.89 ng/mg(OR=3.184,95%CI:1.745~5.777)是H型高血压患者肾损伤的影响因素(P<0.05)。结论血清Visfatin与尿CTGF异常表达与H型高血压患者肾损伤有关,且二者联合的预测效能更佳,有望成为预测H型高血压患者肾损伤的生物标志物。

Objective To explore the predictive value of serum combined with urinary connective tissue growth factor(CTGF)on renal injury in patients with H-type hypertension.Methods A total of 120 patients with H-type hypertension admitted to this hospital from October 2021 to October 2022 were selected as the study group,and 132 healthy people who came to the hospital for physical examination during the same period were selected as the control group.The patients with H-type hypertension were further divided into non-injury group(n=74)and injury group(n=46)according to whether renal injury occurred.The levels of serum Visfatin and urinary CTGF were detected by enzyme-linked immunosorbent assay.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum Visfatin and urinary CTGF for renal injury in patients with H-type hypertension.Multivariate Logistic regression analysis was used to explore the related factors affecting renal injury in patients with H-type hypertension.Results The levels of serum Visfatin and urinary CTGF in the study group were higher compared with the control group(P<0.05).The levels of serum Visfatin and urinary CTGF in patients with H-type hypertension in injury group were higher than those in non-injury group(P<0.05).The area under the ROC curve(AUC)of serum Visfatin and urinary CTGF for predicting renal injury in patients with H-type hypertension were 0.811(95%CI:0.766-0.864)and 0.786(95%CI:0.743-0.829).The AUC of serum Visfatin combined with urinary CTGF was 0.915(95%CI:0.879-0.957),the sensitivity was 87.38%,and the specificity was 84.42%.Albumin and glomerular filtration rate of patients in injury group were lower than those in non-injury group(P<0.05),and the contents of urine protein,urea nitrogen,serum creatinine,and serum uric acid of patients in injury group were higher than those in non-injury group(P<0.05).Serum creatinine>103.53μmol/L(OR=2.257,95%CI:1.241-4.103),glomerular filtration rate≤92.28 mL/(min·1.73 m^(2))(OR=2.633,95%CI:1.412-4.910),Visfatin≥9.18μg/L(OR=3.959,95%CI:1.854-8.453),CTGF≥30.89 ng/mg(OR=3.184,95%CI:1.745-5.777)were t he related factors of renal injury in patients with H-type hypertension(P<0.05).Conclusion Abnormal expression of serum Visfatin and urinary CTGF is associated with renal injury in patients with type H hypertension.The combination of the two indicators has better predictive efficacy,which are expected to be biomarkers for predicting renal injury in patients with H-type hypertension.