慢性肾小球肾炎患者血清HGF、Cys-C、TAFI水平变化及其临床诊断价值

目的:分析慢性肾小球肾炎患者血清肝细胞生长因子(HGF)、胱抑素C(Cys-C)、凝血酶激活的纤溶抑制物(TAFI)水平的变化及其临床诊断价值。方法:选择我院2017年1月～2018年5月收治的71例慢性肾小球肾炎患者作为慢性肾小球肾炎组及同期于本院进行健康体检的83例作为健康对照组。检测进而比较两组血清HGF、Cys-C、TAFI水平,分析以上指标和患者肾功能的相关性及对慢性肾小球肾炎的诊断价值。结果:慢性肾小球肾炎组血清HGF、Cys-C、TAFI水平均显著高于对照组(P0.05)。慢性肾小球肾炎患者治疗后血清HGF、Cys-C、TAFI水平均显著低于治疗前(P0.05)。慢性肾小球肾炎患者血清HGF、Cys-C、TAFI水平和肾功能指标(肌酐(Scr)、尿素氮(BUN)、尿酸(UA))均呈显著正相关(P均0.05)。血清HGF水平诊断慢性肾小球肾炎的曲线下面积为0.826,敏感度和特异度分别为0.747和0.746;血清Cys-C水平诊断慢性肾小球肾炎的曲线下面积为0.821,敏感度和特异度分别为0.687和0.859;血清TAFI水平诊断慢性肾小球肾炎的曲线下面积为0.816,敏感度和特异度分别为0.855和0.647;血清HGF、Cys-C、TAFI水平联合检测诊断慢性肾小球肾炎的曲线下面积为0.951,敏感度和特异度分别为0.831和0.757。结论:慢性肾小球肾炎患者血清HGF、Cys-C及TAFI水平均明显升高,联合检测血清HGF、Cys-C及TAFI可能作为慢性肾小球肾炎诊断及预评估参考指标。

Changes of Serum Levels of HGF, Cys-C and Tafi in the Patients with Chronic Glomerulonephritis and Their Clinical Diagnostic Value

ABSTRACT Objective: To analyze the changes of serum hepatocyte growth factor (HGF), cystatin C (Cys-C) and thrombin activated fibrinolytic inhibitor (TAFI) in patients with chronic glomerulonephritis and their clinical diagnostic value. Methods: 71 cases of chronic glomerulonephritis admitted and treated in our hospital from January 2017 to May 2018 were selected as the chronic glomerulonephritis group and 83 cases of healthy subjects for physical examination in our hospital were selected as the healthy control group. The serum levels of HGF, Cys-C and TAFI in the two groups were compared, the correlation between the above indicators and renal function of patients were analyzed to evaluate their diagnostic value for the chronic glomerulonephritis. Results: The serum levels of HGF, Cys-C and TAFI in the chronic glomerulonephritis group were significantly higher than those in the control group (P<0.05). The serum levels of HGF, Cys-C and TAFI in patients with chronic glomerulonephritis after treatment were significantly lower than those before treatment (P<0.05). The serum levels of HGF, Cys-C, TAFI and renal function indexes (creatinine (Scr), urea nitrogen (BUN), uric acid (UA)) were significantly positively correlated in patients with chronic glomerulonephritis (all P<0.05). The area under the curve for the diagnosis of chronic glomerulonephritis by serum HGF level was 0.826, and the sensitivity and specificity were 0.747 and 0.746. The area under the curve for the diagnosis of chronic glomerulonephritis was 0.821, and the sensitivity and specificity were 0.687 and 0.859, respectively. The subcurve area, sensitivity and specificity of serum TAFI in the diagnosis of chronic glomerulonephritis were 0.816, 0.855 and 0.647. The combined detection of serum HGF, cys-c and TAFI levels in the diagnosis of chronic glomerulonephritis was 0.951 under the curve, and the sensitivity and specificity were 0.831 and 0.757. Conclusion: The serum levels of HGF, Cys-C and TAFI may be involved in the pathogenesis of chronic glomerulonephritis, which can be used as diagnostic and prognostic indicators for the chronic glomerulonephritis.