摘要
目的探讨血清微小RNA(miR)-181a-5p、miR-132-5p水平与慢性肾小球肾炎患者3年内预后的关系。方法选取2018年1月—2020年4月中国人民解放军联勤保障部队第九〇一医院肾内科收治的慢性肾小球肾炎患者128例作为慢性肾小球肾炎组(肾炎组)和体检健康者130例作为健康对照组(对照组)。检测2组肾功能指标、血清miR-181a-5p、miR-132-5p水平;分析血清miR-181a-5p、miR-132-5p与肾功能指标的相关性,影响慢性肾小球肾炎患者3年内预后不良的因素,血清miR-181a-5p、miR-132-5p及二者联合预测慢性肾小球肾炎患者3年内预后不良的价值。结果与对照组比较,肾炎组血清miR-181a-5p、miR-132-5p水平显著降低(t/P=47.860/<0.001、75.095/<0.001),血清尿酸(UA)、血尿素氮(BUN)、血肌酐(SCr)、胱抑素C(CysC)水平显著升高,肾小球滤过率(eGFR)水平显著降低(t=27.103、16.387、37.145、47.506、28.550,P均<0.001);血清miR-181a-5p与miR-132-5p水平呈正相关,血清miR-181a-5p和miR-132-5p均与UA、BUN、Scr、CysC水平呈负相关,与eGFR水平呈正相关(r=0.572、-0.506、-0.514、-0.493、-0.627、0.605、-0.498、-0.546、-0.481、-0.609、0.612,P均<0.001);与预后良好亚组比较,预后不良亚组血清UA、BUN、SCr、CysC水平显著升高,eGFR、血清miR-181a-5p、miR-132-5p水平显著降低(t=6.730、3.596、10.629、7.760、12.657、8.881、13.932,P均<0.001);高水平UA、高水平BUN、高水平SCr、高水平CysC、低水平eGFR、低水平miR-181a-5p、低水平miR-132-5p是影响慢性肾小球肾炎患者3年内预后不良的危险因素[OR(95%CI)=2.239(1.256~3.992)、2.768(1.237~6.194)、2.173(1.195~3.950)、1.806(1.204~2.709)、3.022(1.620~5.637)、2.565(1.349~4.879)、3.350(1.226~9.157)];血清miR-181a-5p、miR-132-5p及二者联合预测慢性肾小球肾炎患者3年内预后不良的曲线下面积(AUC)分别为0.832、0.801、0.904,其中二者联合预测的AUC显著高于各自单独预测AUC(Z/P=1.714/0.043、2.050/0.020)。结论慢性肾小球肾炎患者血清miR-181a-5p、miR-132-5p水平较低,二者与肾功能关系密切,二者联合有助于评估患者3年内预后情况。
Objective To investigate the relationship between serum microRNA-181a-5p and miR-132-5p levels and the 3-year prognosis of patients with chronic glomerulonephritis.Methods One hundred and twenty-eight patients with chronic glomerulonephritis admitted to the Nephrology Department of the 901 Hospital of the Chinese People's Liberation Army Joint Logistics Support Force from January 2018 to April 2020 were selected as the chronic glomerulonephritis group(nephritis group)and 130 healthy individuals who underwent physical examinations were selected as the healthy control group(control group).Detect two groups of renal function indicators,serum miR-181a-5p,and miR-132-5p levels;Analyze the correlation between serum miR-181a-5p,miR-132-5p and renal function indicators,identify factors affecting poor prognosis within 3 years in patients with chronic glomerulonephritis,and evaluate the value of serum miR-181a-5p,miR-132-5p,and their combination in predicting poor prognosis within 3 years in patients with chronic glomerulonephritis.Results Compared with the control group,the levels of serum miR-181a-5p and miR-132-5p in the nephritis group were significantly reduced(t/P=47.860/<0.001,75.095/<0.001),while the levels of serum uric acid(UA),blood urea nitrogen(BUN),blood creatinine(SCR),and cystatin C(CysC)were significantly increased.The level of glomerular filtration rate(eGFR)was significantly reduced(t=27.103,16.387,37.145,47.506,28.550,all P<0.001).Serum miR-181a-5p is positively correlated with miR-132-5p levels,while serum miR-181a-5p and miR-132-5p are negatively correlated with UA,BUN,Scr,CysC levels,and positively correlated with eGFR levels(r=0.572,-0.506,-0.514,-0.493,-0.627,0.605,-0.498,-0.546,-0.481,-0.609,0.612,all P<0.001).Compared with the subgroup with good prognosis,the subgroup with poor prognosis showed a significant increase in serum UA,BUN,SCr,and CysC levels,while eGFR,serum miR-181a-5p,and miR-132-5p levels significantly decreased(t=6.730,3.596,10.629,7.760,12.657,8.881,13.932,all P<0.001).High levels of UA,BUN,SCr,CysC,eGFR,miR-181a-5p,and miR-132-5p are risk factors for poor prognosis within 3 years in patients with chronic glomerulonephritis[OR(95%CI)=2.239(1.256-3.992),2.768(1.237-6.194),2.173(1.195-3.950),1.806(1.204-2.709),3.022(1.620-5.637),2.565(1.349-4.879),3.350(1.226-9.157)].The area under the curve(AUC)of serum miR-181a-5p,miR-132-5p,and their combined prediction of poor prognosis within 3 years in patients with chronic glomerulonephritis were 0.832,0.801,and 0.904,respectively.The AUC predicted by the combination of the two was significantly higher than that predicted by each individual(Z/P=1.714/0.043,2.050/0.020).Conclusions Patients with chronic glomerulonephritis have lower levels of serum miR-181a-5p and miR-132-5p,which are closely related to renal function.The combination of the two can help evaluate the patient's prognosis within 3 years.
作者
黄其峰
童薇
刘洋
江小伟
刘萍
Huang Qifeng;Tong Wei;Liu Yang;Jiang Xiaowei;Liu Ping(Department of Blood Transfusion and Laboratory,901st Hospital of Joint Logistic Support Force of PLA,Anhui Province,Hefei 230031,China;不详)
出处
《疑难病杂志》
CAS
2024年第2期196-201,共6页
Chinese Journal of Difficult and Complicated Cases
基金
安徽省卫生健康委科研项目(AHWJ2021b094)。
