摘要
目的探讨慢性肾脏病(chronic kidney disease,CKD)不同分期血清Klotho蛋白水平的变化及其意义。方法选取2015年3月至2017年12月内蒙古自治区人民医院肾内科收治的176例CKD患者为研究对象(CKD组),同期选取我院80名健康体检者为对照组,采用双抗体夹心酶联免疫吸附(ELISA)法检测不同分期的CKD患者及对照组血清Klotho浓度,并比较各组之间的差异。结果CKD组血清Klotho水平[(4.84±1.87)μg/L]显著低于对照组[(9.11±3.14)μg/L](t=13.82,P<0.01)。单因素方差分析显示CKD1期~CKD5期估测肾小球滤过率(estimated glomerular filtration rate,eGFR)、血清白蛋白(albumin,ALB)、血红蛋白(hemoglobin,Hb)、血钙(calcium,Ca)、血清Klotho逐渐降低,而血磷(phosphorus,P)、血肌酐(creatinine,Cr)逐渐升高,此五期患者之间比较差异均有统计学意义(P均<0.01);Spearman相关性分析显示Klotho水平与eGFR、Ca呈正相关,与CKD分期、Cr、P呈负相关(r值分别为0.369、0.160、-0.200、-0.250、-0.230,P均<0.05)。多元线性回归方程显示,Klotho水平与eGFR呈独立正相关(t=3.89,P<0.01),与CKD分期呈独立负相关(t=-4.12,P<0.001)。结论CKD患者中血清Klotho蛋白表达水平低于健康人群,且随着CKD分期的增加而不断降低,且与肾功能恶化密切相关,可作为一个评估CKD发病及病情严重程度的参考指标。
Objective To explore the changes and significance of Klotho protein levels in different stages of chronic kidney disease(CKD).Methods From March 2015 to December 2017,176 patients with CKD admitted to nephrology department of Inner Mongolia People's Hospital were selected as the study object(CKD group),and 80 healthy patients in our hospital were selected as the control group in the same period.The serum Klotho levels of CKD patients and control group at different stages were detected by double antibody sandwich ELISA,and the differences between each group were compared.Results The serum Klotho level of CKD group((4.84±1.87)μg/L)was significantly lower than that of the control group((9.11±3.14)μg/L)(t=13.82,P<0.01).One-way anova showed that estimated renal glomerular filtration rate(eGFR),serum albumin(ALB),hemoglobin(Hb),blood calcium(Ca)and serum Klotho were gradually decreased,while phosphorus(P)and creatinine(Cr)in serum were gradually increased,and the difference was statistically significant among the five stages(all P<0.01).Spearman correlation analysis showed that Klotho level was positively correlated with eGFR and Ca,and negatively correlated with CKD stage,Cr and P(r=0.369,0.160,-0.200,-0.250,-0.230,all P<0.05).The multiple linear regression equation showed that Klotho level was positively and independently correlated with eGFR(t=3.89,P<0.001),and negatively correlated with CKD staging independently(t=-4.12,P<0.001).Conclusion The expression level of serum Klotho protein in patients with CKD is lower than that of healthy people,and it decreases with the increase of CKD stages,which is closely related to the deterioration of renal function.It can be used as a reference index to evaluate the incidence and severity of CKD.
作者
刘艾芹
于磊
朱立革
张德鱼
马继玲
Liu Aiqin;Yu Lei;Zhu Lige;Zhang Deyu;Ma Jiling(Department of nephrology,Inner Mongolia People's Hospital,010010)
出处
《中国综合临床》
2019年第6期536-540,共5页
Clinical Medicine of China
关键词
慢性肾脏疾病
KLOTHO蛋白
CKD分期
估测肾小球滤过率
肾功能
Chronic kidney disease
Klotho protein
Chronic kidney disease stage
Estimated glomerular filtration rate
Renal function
