摘要
目的:探讨外周血sCD146水平检测在评估慢性肾脏疾病(CKD)进程中的意义及其与肾功能的关系。方法:入选84例CKD患者,CKD3期15例,CKD4期21例,CKD 5期48例,其中非透析组(CKD 5-ND)11例,腹透组(CKD 5-PD)22例,血透组(CKD5-HD)15例。设20例健康对照。采用ELISA法检测sCD146水平。分析sCD146的变化及其相关因素,特别是与肾功能的关系。结果:各组CKD患者sCD146水平[CKD3(290.14±28.52)ng/ml,CKD4(348.37±26.96)ng/ml,CKD5-ND(426.42±30.72)ng/ml,CKD5-PD(460.29±42.11)ng/ml,CKD 5-HD(467.45±69.05)ng/ml],均显著高于对照组(206.40±29.39)ng/ml。sCD146水平随着CKD3~5期进展而逐渐升高(P<0.05),而且血透和腹透组患者的sCD146水平分别高于CKD5-ND组。相关分析表明sCD146与Scr、β2-MG、CRP呈正相关,与GFR和血红蛋白呈负相关。多因素逐步回归分析显示GFR和β2-MG是影响sCD146水平的独立因素。结论:sCD146能较好地反映CKD患者的肾功能进展情况;sCD146在CKD患者中的表达增强一定程度上反映了血管内皮功能状况,与慢性炎症状态有关。
Objective:To detect the level of soluble CD146(sCD146) and explore its relationship with renal fuction in patients with chronic kidney disease(CKD).Methods:A total of 84 CKD patients,including 15 cases of CKD3,21 cases of CKD4,48 cases of CKD5 with 11 non-dialysis cases(CKD5-ND),22 peritoneal dialysis casese (CKD5-PD) and 15 hemodialysis cases(CKD5-HD).20 healthy volunteers were enrolled as control.Serum levels of CD146 were measured by ELISA.Results:The serum levels of CD146 in each CKD group are [CKD3(290.14±28.52)ng/ml,CKD4(348.37±26.96)ng/ml,CKD5-ND(426.42±30.72)ng/ml,CKD5-PD(460.29±42.11)ng/ml,CKD5-HD(467.45±69.05)ng/ml],which is significantly higher than in control group(206.40±29.39)ng/ml.Serum CD146 levels were gradually increased according to the progression of renal impairment from CKD3 to CKD5(P0.05),and that in the peritoneal or hemodialysis group,sCD146 was significantly higher than in CKD5-ND group.sCD146 level was positively correlated with Scr,β2 microglobulin and CRP,and negatively correlated with GFR and hemoglobin.In stepwised regression analysis,GFR and β2 microglobulin remain the only independent factors of sCD146 levels.Conclusion:sCD146 could be a new biomarker of renal function and may show renal impairment in the different stages of CKD.Serum CD146 may closely associate with the endothelial dysfunction and chronic inflammation.
出处
《中国中西医结合肾病杂志》
2010年第9期781-785,共5页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
上海市科委自然基金资助项目(No.05ZR14086)
上海市医苑新星项目(No.02xx46)