【摘要】 目的分析女性1型心肾综合征(CRS)患者血清人附睾蛋白4(HE4)水平变化及其临床意义。方法选取2015—2017年武汉大学人民医院收治的女性1型CRS患者75例作为观察组,另选取同期体检健康女性79例作为对照组。比较两组受试者年龄、血压及血清HE4、肌酐(Cr)、尿素氮(BUN)、尿酸(UA)水平,不同纽约心脏病协会(NYHA)分级的女性1型CRS患者血清HE4、Cr、BUN、UA水平;血清HE4水平与女性1型CRS患者血清Cr、BUN、N末端脑钠肽前体(NT-pro BNP)水平的相关性分析采用Spearman秩相关分析,并绘制ROC曲线以评价血清HE4、Cr、BUN水平对女性1型CRS的诊断价值。结果两组受试者年龄、收缩压、舒张压比较,差异无统计学意义(P>0.05);观察组患者血清HE4、Cr、BUN、UA水平高于对照组(P<0.05)。NYHA分级Ⅲ级和Ⅳ级患者血清HE4、Cr水平高于Ⅱ级患者,NYHA分级Ⅳ级患者血清HE4、Cr水平高于Ⅲ级患者(P<0.05)。不同NYHA分级患者血清BUN、UA水平比较,差异无统计学意义(P>0.05)。Spearman秩相关分析结果显示,血清HE4水平与女性1型CRS患者血清Cr(r_s=0.520)、BUN(r_s=0.369)、NT-pro BNP(r_s=0.344)水平呈正相关(P<0.05);绘制血清HE4、Cr、BUN水平诊断女性1型CRS的ROC曲线,结果显示,血清HE4水平诊断女性1型CRS的曲线下面积(AUC)为0.999[95%CI(0.997,1.000)],血清Cr水平为0.923[95%CI(0.878,0.969)],血清BUN水平为0.810[95%CI(0.745,0.875)]。结论女性1型CRS患者血清HE4水平明显升高,且其与患者心、肾功能损伤程度有关,对女性1型CRS的诊断价值较高。更多还原

【Abstract】 Objective To analyze the change and clinical significance of serum HE4 level in female patients with type 1 cardio-renal syndrome. Methods From 2015 to 2017 in Renmin Hospital of Wuhan Univer_sity,75 female patients with type 1 cardio-renal syndrome were selected as observation group,79 healthy females admitted to this hospital for physical examination were selected as control group. Age,blood pressure,serum levels of HE4,Cr,BUN and UA were compared between the two groups,meanwhile serum levels of HE4,Cr,BUN and UA were compared in the female type 1 cardiorenal syndrome patients with different NYHA grades;Spearman rank correlation analysis was used to analyze the correlations of serum HE4 level with serum levels of Cr,BUN and NT-pro BNP,and ROC curve was used to evaluate the diagnostic value of serum levels HE4,Cr,BUN on type 1 cardiorenal syndrome. Results No statistically significant differences of age,SBP or DBP was found between the two groups(P>0.05),while serum levels of HE4,Cr,BUN and UA in observation group were statistically significantly higher than those in control group(P<0.05). Serum levels of HE4 and Cr in female type 1 cardio-renal syndrome patients with Ⅲ-and Ⅳ-NYHA grade were statistically significantly higher than those in patients with Ⅱ-NYHA grade,meanwhile serum levels of HE4 and Cr in female type 1 cardio-renal syndrome patients with Ⅳ-NYHA grade were statistically significantly higher than those in patients with Ⅲ-NYHA grade(P<0.05);no statistically significant differences of serum level of BUN or UA was found in female type 1 cardio-renal syndrome patients with different NYHA grades(P>0.05). Spearman rank correlation analysis results showed that,serum HE4 level was positively correlated with serum level of Cr(r_s=0.520),BUN(r_s=0.369) and NT-pro BNP(r_s=0.344)in female patients with type 1 cardio-renal syndrome,respectively(P<0.05);ROC curve showed that,AUC of serum HE4 level in diagnosing female type 1 cardio-renal syndrome was 0.999[95%CI(0.997,1.000)],that of serum Cr level was 0.923[95%CI(0.878,0.969)],that of serum BUN level was 0.810[95%CI(0.745,0.875)]. Conclusion Serum HE4 level is significantly elevated in female patients with type 1 cardio-renal syndrome,and it is significantly correlated with damage degree of cardiac and renal function,has relatively high diagnostic value on female type 1 cardiorenal syndrome.更多还原