摘要
目的研究血清胱抑素C、内皮素-1、转化生长因子-β1(TGF-β1)预测高尿酸血症(HUA)非布司他治疗后疗效的价值。方法回顾性分析2021年1月至2023年1月在武警山西总队医院收治的160例HUA患者的临床资料,所有患者均口服非布司他进行治疗,根据患者使用非布司他治疗3个月后的疗效情况分为有效组(n=118)和无效组(n=42)。观察两组基础资料信息[性别、年龄、体重指数、病程、疾病类型、合并高血压、合并糖尿病、血肌酐、肾小球过滤率(GFR)、血尿酸、胱抑素C、内皮素-1、TGF-β1水平]差异。采用多因素Logistic回归分析影响HUA患者非布司他治疗效果的危险因素。绘制受试者操作特征(ROC)曲线评估血清胱抑素C、内皮素-1、TGF-β1预测HUA患者非布司他治疗效果的效能。结果两组性别构成比、年龄、体重指数、病程、疾病类型、合并高血压、合并糖尿病、血肌酐、eGFR比较,差异均无统计学意义(P>0.05);无效组的血尿酸、胱抑素C、内皮素-1、TGF-β1水平分别为(435.89±33.05)μmol/L、(10.84±1.65)mg/L、(32.81±5.55)ng/L、(25.74±4.85)ng/mL,均显著高于有效组[(351.85±24.76)μmol/L、(8.15±1.43)mg/L、(24.56±4.12)ng/L、(19.28±3.62)ng/mL],差异均有统计学意义(P<0.05)。经多因素Logistic回归分析证实,血清血尿酸、胱抑素C、内皮素-1、TGF-β1高水平均是影响HUA患者非布司他治疗无效的危险因素(P<0.05)。经ROC分析证实,血清胱抑素C、内皮素-1、TGF-β1可用于HUA患者非布司他治疗效果的预测,曲线下面积分别为0.917、0.853、0.825,预测价值较好(P<0.05)。结论血清血尿酸、胱抑素C、内皮素-1、TGF-β1高水平均是影响HUA患者非布司他治疗效果的危险因素,可将以上指标作为评估HUA患者非布司他治疗效果的标志物,为临床降低HUA治疗无效风险提供参考。
Objective To investigate the value of serum cystatin C,endothelin-1 and transforming growth factor-β1(TGF-β1)in predicting the efficacy of febuxostat after hyperuricemia(HUA).Methods The clinical data of 160 cases of HUA admitted to Shanxi General Hospital of Chinese People's Armed Police Force from January 2021 to January 2023 were retrospectively analyzed.All patients were treated with feburestat orally,and were divided into effective group(n=118)and ineffective group(n=42)according to the efficacy of feburestat treatment for 3 months.The differences of basic information[gender,age,body mass index,course of disease,type of disease,combined hypertension,combined diabetes,serum creatinine,glomerular filtration rate(GFR),blood uric acid,cystatin C,endothelin-1,TGF-β1]were observed between the two groups.Multivariate Logistic regression was used to analyze the risk factors affecting the treatment failure of HUA febuxostat,and the efficacy of serum cystatin C,endothelin-1 and TGF-β1 in predicting the treatment failure of HUA febuxostat was evaluated by drawning receiver operating characteristic(ROC)curve.Results There were no significant differences in gender,age,body mass index,disease course,disease type,combined hypertension,combined diabetes,serum creatinine and eGFR between the two groups(P>0.05).The levels of blood uric acid,cystatin C,endothelin-1 and TGF-β1 in ineffective group were(435.89±33.05)μmol/L,(10.84±1.65)mg/L,(32.81±5.55)ng/L,(25.74±4.85)ng/mL,which were significantly higher than those in effective group[(351.85±24.76)μmol/L,(8.15±1.43)mg/L,(24.56±4.12)ng/L,(19.28±3.62)ng/mL],the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis confirmed that the high levels of serum blood uric acid,cystatin C,endothelin-1 and TGF-β1 were the risk factors for the ineffective treatment of HUA febuxoat(P<0.05).ROC analysis confirmed that serum cystatin C,endothelin-1 and TGF-β1 could be used to predict the therapeutic effect of HUA Febuxostat,and the areas under the curve were 0.917,0.853 and 0.825,respectively,with good predictive value(P<0.05).Conclusion The high levels of serum blood uric acid,cystatin C,endothelin-1 and TGF-β1 are all risk factors affecting the therapeutic treatment of HUA febuxoat.These indicators can be used as markers to evaluate the therapeutic effect of HUA febuxoat,and provide references for reducing the risk of the therapeutic treatment of HUA.
作者
王岚
张懿芳
武众众
李霞
赵斌燕
李楠
WANG Lan;ZHANG Yi-fang;WU Zhong-zhong(Department of Health and Epidemic Prevention,Shanxi General Hospital of Chinese People's Armed Police Force,Taiyuan Shanxi 030006,China)
出处
《临床和实验医学杂志》
2024年第9期937-941,共5页
Journal of Clinical and Experimental Medicine
基金
山西省卫健委科研基金项目(编号:2021066)
