摘要
目的探讨血及尿内皮素1(ET-1)、白介素6(IL-6)应用于动脉粥样硬化性肾动脉狭窄(ARAS)筛查的可能性。方法检测49例不同狭窄程度的ARAS患者,32例合并≥2项动脉粥样硬化危险因素的非ARAS患者及30例正常对照的血及尿ET-1、IL-6水平,构建其诊断ARAS的受试者工作特征曲线(ROC曲线)。结果尿ET-1、尿IL-6及尿ET-1/血ET-1比值与肾动脉狭窄程度相关。在用于诊断狭窄程度≥50%的ARAS患者时,其ROC曲线下面积分别为0.792、0.756及0.779。尿ET-1以6.72 ng/mmol肌酐为界值时,诊断ARAS的敏感度为80.0%,特异度为72.8%。尿ET-1/血ET-1比值以12.59为界值时,敏感度为66.7%,特异度为61.7%。而尿IL-6以23.85 ng/mmol肌酐为界值时,敏感度为73.3%,特异度为70.4%。若采用系列研究方法,尿IL-6以12.60ng/mmol肌酐为界值并联用高血压这一临床指标时,敏感度和特异度可提高至80.0%与77.8%。结论尿ET-1及尿IL-6有应用于ARAS筛查的可能性。
Objective To investigate the possibility of using serum and urinary endothelin-1 （ET-1）, interleukin-6 （IL-6） assay as screening tools for atherosclerotic renal artery stenosis （ARAS）. Methods Serum and urinary samples from 49 patients with ARAS, 32 cases with ≥ 2 risk factors for atherosclerosis and 30 normal controls were detected for ET-1 and IL-6 by RIA. The receiver operating characteristic （ROC） curves were then generated to assess their accuracy in screening ARAS by using selective renal angiography as golden standard. Results Urinary ET-1, urinary IL-6 and urinary-serum ratio of ET-1 in ARAS cases were higher than those in two control groups, and were all correlated with degree of renal artery stenosis. The area under the ROC curve of urinary ET-1, urinary IL-6 and urinary-serum ratio of ET-I was 0.792, 0.756 and 0.779, respectively. The sensitivity and specificity of urinary ET-1 to distinguish ARAS （I〉50%） was 80.0% and 72.8% respectively using 6.72 ng/mmol creatinine as the cut-off point. The cut-off value of ET-1 urinary-serum ratio was 12.59 with a sensitivity of 66.7% and a specificity of 61.7%. The sensitivity and specificity of urinary IL-6 were 73.3% and 70.4% respectively using 23.85 ng/mmol creatinine as the cut-off point. The sensitivity and specificity were improved to 80.0% and 77.8% respectively when using 12.60 ng/mmol creatinine as the cut-off point and combined with hypertension to perform series test. Conclusion Urinary ET-1 and urinary IL-6 could be used as screening tools for ARAS.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2005年第11期672-676,共5页
Chinese Journal of Nephrology
基金
卫生部临床学科重点项目(20010913)
关键词
动脉粥样硬化
肾动脉狭窄
内皮素1
白介素6
诊断
Atherosclerosis
Renal artery stenosis
Endothelin- 1
Interleukin- 6
Diagnosis
