铜蓝蛋白、鳞状细胞癌相关抗原与慢性肾功能衰竭的关系及对病情进展的预测价值研究

摘要 目的：分析铜蓝蛋白（CER）、鳞状细胞癌相关抗原（SCCA）与慢性肾功能衰竭的关系及对病情进展的预测价值。方法：选择我院自2019年4月至2021年4月接诊的169例慢性肾功能衰竭患者作为研究对象，根据24 h尿白蛋白定量分为微量白蛋白尿组（＜200 mg/24 h，102例）和大量白蛋白尿组（＞200 mg/24 h，67例）。比较两组各项实验室指标及血清CER、SCCA水平，分析CER、SCCA与慢性肾功能衰竭患者肾功能指标的关系。随访12个月，观察病情进展，使用受试者工作特征曲线（ROC）评价血清CER联合SCCA对病情进展的预测效能。结果：大量白蛋白尿组血清肌酐（Scr）、血尿素氮（BUN）水平均明显高于微量白蛋白尿组，肾小球滤过率（GFR）低于微量白蛋白尿组（P＜0.05）；大量白蛋白尿组血清CER、SCCA水平均高于微量白蛋白尿组（P＜0.05）；经Pearson相关性分析，慢性肾功能衰竭患者血清CER、SCCA水平均与Scr、BUN呈正相关，与GFR呈负相关（P＜0.05）；经多因素Logistic回归分析，GFR、CER、SCCA均是慢性肾功能衰竭患者病情进展的独立预测因素（P＜0.05）；经ROC曲线分析，血清CER联合SCCA预测慢性肾功能衰竭患者病情进展的AUC为0.925，明显大于GFR的0.620（P＜0.05）。结论：血清CER、SCCA水平与慢性肾功能衰竭患者肾功能呈负相关，联合预测病情进展效能较好，值得临床予以重视应用。

The Relationship between Ceruloplasmin, Squamous Cell Carcinoma Antigen and Chronic Renal Failure and The Predictive Value of Disease Progression

ABSTRACT Objective: To analyze the relationship between ceruloplasmin (CER), squamous cell carcinoma associated antigen (SCCA) and chronic renal failure (CRF) and their predictive value for disease progression. Methods: A total of 169 patients with chronic renal failure admitted to our hospital from April 2019 to April 2021 were selected as the study subjects. According to 12 h urinary albumin quantification,the patients were divided into microalbuminuria group (<200 mg/24 h, 102 cases) and macroalbuminuria group (>200 mg/24 h, 67 cases). The laboratory indexes and serum CER and SCCA levels of the two groups were compared, and the relationship between CER, SCCA and renal function indexes of patients with chronic renal failure was analyzed. Patients were followed up for 24 months to observe the progression of the disease. Area under receiver operating Characteristic Curve(AUC) was used to evaluate the predictive efficacy of CER combined with SCCA on the progression of the disease. Results: The levels of serum creatinine(Scr) and blood urea nitrogen(BUN) in moderate proteinuria group were higher than those in mild proteinuria group, and the glomerular filtration rate (GFR) was lower than that in mild proteinuria group (P<0.05). The levels of CER and SCCA in moderate proteinuria group were higher than those in mild proteinuria group(P<0.05). Pearson correlation analysis showed that CER and SCCA levels were positively correlated with Scr and BUN, but negatively correlated with GFR(P<0.05). Multivariate Logistic regression analysis showed that GFR,CER and SCCA were independent predictors of chronic renal failure(P<0.05). According to ROC curve analysis, the AUC of CER combined with SCCA in predicting the progression of chronic renal failure was 0.926,which was significantly higher than 0.683 of GFR(P<0.05). Conclusion: The levels of CER and SCCA are negatively correlated with renal function in patients with chronic renal failure. The combined efficacy of CER and SCCA in predicting the progression of patients'' disease is good and worthy of clinical attention.