摘要
目的评价可溶性血栓调节蛋白(sTM)对评估肾脏病患者内皮损伤状态的价值。方法收集2020年9月至2021年1月首次就诊于北京医院肾内科的患者133例,以同期健康体检者130名作为对照组。根据患者的年龄、性别、原发病、合并症、并发症等信息进行分组,分析不同疾病及不同肾脏病分期患者sTM、血肌酐等指标的差异。结果对于慢性肾脏病(CKD)患者,随着肾功能的减退,sTM明显升高,CKD 1~5期患者sTM水平分别为(0.013±0.007)、(0.019±0.010)、(0.022±0.008)、(0.027±0.008)、(0.033±0.006)TU/L,差异有统计学意义(F=21.005,P<0.05);非CKD的尿路感染患者sTM水平为(0.013±0.009)TU/L,与CKD 1期患者比较,差异无统计学意义(t=1.023,P>0.05)。无论患者是否合并感染或心血管疾病,在血肌酐匹配的情况下,sTM水平差异均无统计学意义(均P>0.05)。4例急性肾损伤患者经过积极治疗,血肌酐恢复正常,但sTM未明显下降。sTM与血肌酐呈正相关(r=0.697,P<0.01)。结论sTM能更早期地评估CKD患者的肾功能损伤,肾脏病患者的sTM水平与内皮损伤程度相关。
Objective To evaluate the value of soluble thrombomodulin(sTM)in evaluating endothelial injury in patients with kidney disease.Methods One hundred and thirty-three patients who first visited the Department of Nephrology of Beijing hospital for various reasons from September 2020 to January 2021 and 130 healthy people were collected and divided into groups according to age,gender,primary disease,complications and so on.The differences of sTM and serum creatinine in patients with different diseases and renal disease stages were analyzed.Results For patients with chronic kidney disease(CKD),sTM increased significantly with the decrease of renal function.The level of sTM in patients with CKD stage 1-5 was(0.013±0.007),(0.019±0.010),(0.022±0.008),(0.027±0.008),(0.033±0.006)TU/L,respectively(F=21.005,P<0.05).There was no significant difference in the level of sTM between patients with non-CKD urinary tract infection(0.013±0.009)TU/L and patients with stage 1 CKD(t=1.023,P>0.05).No matter whether the patients were complicated with infection or cardiovascular disease,there was no significant difference in sTM level under the condition of serum creatinine matching(all P>0.05).In 4 patients with acute renal injury,serum creatinine returned to normal after active treatment,but sTM did not decrease significantly.Correlation analysis showed that there was a positive correlation between sTM and serum creatinine(r=0.697,P<0.01).Conclusion sTM can evaluate the renal function damage of patients with CKD more early,and the level of sTM in patients with renal disease is more related to the degree of endothelial damage.
作者
李传保
徐冷楠
步霄霄
刘梦欣
Li Chuanbao;Xu Lengnan;Bu Xiaoxiao;Liu Mengxin(Department of Laboratory Medicine,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Nephrology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2021年第23期1812-1815,共4页
National Medical Journal of China
基金
中央高校基本科研项目(BJ-2020-056)。
关键词
血栓调节蛋白
肾病
内皮损伤
Thrombomodulin
Nephrosis
Endothelial injury
