肾移植术后慢性肾病患者血清人附睾蛋白4水平变化及临床意义

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Abstract Objective To analyze the changes and clinical significance of serum human epididymal protein 4 (HE4) in patients with chronic kidney disease (CKD) after kidney transplantation. Methods A total of 87 patients with CKD after kidney transplantation who were followed up in Huizhou Central People′s Hospital and Guangdong Hospital of Traditional Chinese Medicine from January 2014 to June 2019 were selected as the study subjects (CKD group), another 50 healthy subjects who underwent physical examination in Huizhou Central People′s Hospital were selected as the control group. The estimated glomerular filtration rate (eGFR) and serum levels of HE4, creatinine (SCr), urea nitrogen (BUN) and urinary β2-microglobulin (β2-MG) were compared between the two groups. The correlation between HE4 and various nephropathy-related indicators was analyzed, the risk factors for CKD were analyzed, and the predictive value of HE4, SCr, BUN, and β2-MG on CKD was plotted by ROC. Results The levels of HE4, SCr, BUN and β2-MG in patients in the CKD group were significantly higher than those in the control group, while the levels of eGFR were lower than those in the control group (P ＜ 0.05). The HE4 level of patients with CKD1 stage was higher than that of the control group, and the difference of HE4 level in different CKD stages was statistically significant (all P ＜ 0.05). The levels of SCr, BUN and 2-MG of CKD stage2 patients were higher than those of the control group, and the differences between SCr, BUN and 2-MG in different CKD stages were statistically significant (all P ＜ 0.05). eGFR in patients with stage2 of CKD was lower than that in the control group, and the differences in eGFR in different stages of CKD were statistically significant (all P ＜ 0.05). There was an obvious positive correlation between HE4 and SCr, BUN and β2-MG in CKD group (r = 0.611, 0.555, 0.539, P ＜ 0.05), while negatively correlated with eGFR(r = -0.762, P ＜ 0.05). Logistic multivariate regression analysis showed that elevated HE4, SCr, BUN and β2-MG levels were all independent risk predictors of CKD (all P ＜ 0.05). HE4 predicted that the ROC area of CKD was 0.877 higher than SCr (0.785), BUN (0.752) and β2-MG (0.778), and the area under ROC of CKD was the highest, up to 0.965. Conclusion After kidney transplantation, serum HE4 level of CKD patients is significantly increased, has a high predictive value for the occurrence of CKD in patients, which could assist in the early diagnosis of CKD in clinical practice.

Key words： Kidney transplantation Chronic kidney disease Human epididymal protein 4 Risk factors Predictive value

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	LUO Boxun1 ZHANG Weiping2 MENG Fanhang3

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LUO Boxun1 ZHANG Weiping2 MENG Fanhang3. Changes and clinical significance of serum human epididymal protein 4 in patients with chronic kidney disease after kidney transplantation[J]. 中国医药导报, 2020, 17(12): 80-84.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I12/80

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