【摘要】：目的:探討尿血管緊張素原(AGT)與慢性腎臟病(CKD)的關聯(lián)性,探討尿AGT對慢性腎臟病的診斷的意義。方法:從慢性腎臟病橫斷面調查的資源標本庫中抽取CKD和非CKD樣本,按照估算的腎小球濾過率(eGFR單位:ml/min/1.73m2)將CKD患者分為3組:正常組(eGFR≥90),臨界組(60≤eGFR90),下降組(30≤eGFR60)。CKD組和非CKD組中在收縮壓80-220mmHg區(qū)間,按每隔20 mmHg進行分組。尿AGT用酶聯(lián)免疫吸附測定法(ELISA)進行檢測。單因素方差分析法分析組間差異,多因素分析采用多重線性回歸分析法。結果:資料完整的95名CKD患者和413名非CKD對照組進入本研究。CKD組尿AGT明顯高于非CKD組(243.97±47.86 vs 158.43±25.14t=16.892 P0.01);隨著腎小球濾過率下降,尿AGT呈升高趨勢,正常組、臨界組和下降組尿AGT分別為213.63±34.47ng/L,251.39±17.17ng/L,314.97±27.58ng/L,各組間有顯著差異(F=81.103 P0.01)。在同一血壓水平下,CKD組中尿AGT均顯著高于非CKD組,差異有統(tǒng)計學意義(P0.01);CKD組中隨著收縮壓升高,尿AGT水平進一步升高,收縮壓在140-160mmHg和160-180mmHg區(qū)間段,差異有統(tǒng)計學意義(P0.01)。多重線性回歸分析顯示,尿AGT與尿白蛋白/肌酐和血肌酐呈正相關,與eGFR呈負相關。結論:慢性腎臟病患者尿AGT高于非CKD者;在CKD患者中隨著收縮壓升高,尿AGT水平進一步升高;尿AGT與尿白蛋白/肌酐和血肌酐呈正相關,與eGFR呈負相關;提示尿血管緊張素原可作為慢性腎臟病早期預測和病程進展的生物學標志物。
[Abstract]:Objective: To investigate the association between urinary angiotensinogen (AGT) and chronic renal disease (CKD), and to explore the significance of urinary AGT in the diagnosis of chronic renal disease. Methods: CKD and non CKD samples were extracted from the resource Specimen Bank of the cross-sectional study of chronic kidney disease, and CKD patients were divided into 3 groups according to the estimated glomerular filtration rate (eGFR unit: ml/min/1.73m2). Group (eGFR > 90), critical group (60 < < eGFR90), decreased group (30 < eGFR60).CKD and non CKD group in systolic pressure 80-220mmHg interval, every 20 mmHg were grouped. Urine AGT was detected by enzyme linked immunosorbent assay (ELISA). Single factor analysis of variance analysis was used to analyze the difference between groups and multiple linear regression analysis was adopted. The urine AGT of 95 CKD patients and 413 non CKD controls was significantly higher than that in the non CKD group (243.97 + 47.86 vs 158.43 + 25.14t=16.892 P0.01). With the decrease of the glomerular filtration rate, the urine AGT showed a tendency to increase. The normal group, the critical group and the descending group of AGT were 213.63 + 34.47ng/L, 251.39 + 17.17ng/L, 314.97 +, respectively. There were significant differences between each group (F=81.103 P0.01). In the same blood pressure level, the urine AGT in CKD group was significantly higher than that in the non CKD group, and the difference was statistically significant (P0.01). In the CKD group, the level of urinary AGT increased with the increase of systolic pressure, and the systolic pressure was in the 140-160mmHg and 160-180mmHg segments, the difference was statistically significant (P0.01). Multiple linear regression scores were found in group CKD. The results showed that urinary AGT was positively correlated with urinary albumin / creatinine and creatinine and negatively correlated with eGFR. Conclusion: the urine AGT of patients with chronic kidney disease is higher than that of non CKD; in patients with CKD, the level of urine AGT increases with the increase of systolic pressure; urinary AGT is positively related to urinary albumin / creatinine and creatinine, and is negatively related to eGFR, suggesting urinary angiotensinogen. It can be used as a biomarker for early prediction and progression of chronic kidney disease.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R692

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