人附睾蛋白4对慢性肾脏疾病的诊断价值研究

摘要

目的：检测人附睾蛋白4（HE4）在慢性肾脏疾病（CKD）中的表达水平，评价 HE4对 CKD 的诊断价值。方法用电化学发光法测定81例 CKD 患者和73名健康对照者（正常对照组）血清 HE4、糖类抗原（CA）125、甲胎蛋白（AFP）、癌胚抗原（CEA）、CA199、CA15－3等指标，采用受试者工作特征（ROC）曲线分析各指标对CKD 各分期的诊断价值。结果 CKD 组血清 HE4、CA125、CEA、CA15－3、尿素、肌酐和尿酸水平均明显高于正常对照组（P ＜0．05），而血清 AFP、CA199水平2组之间差异无统计学意义（P ＞0．05）。 ROC 曲线分析显示 HE4对 CKD 的诊断性能最佳，其曲线下面积均大于血清肌酐、尿素和尿酸。 CKD 不同分期患者之间血清 HE4、CEA、尿素、肌酐和尿酸水平差异均有统计学意义（P 均＜0．005），且随病情严重程度的增加而增高。 ROC 曲线分析显示血清 HE4、尿素、肌酐和尿酸水平对4～5期 CKD 均具有明显的诊断意义，曲线下面积均＞0．9。结论 HE4对 CKD 具有极好的辅助诊断价值，且 HE4值还与 CKD 的严重程度有关，对判断 CKD 的分期有重要的临床意义。%Objective To determine the level of human epididymis protein 4(HE4), and to evaluate its diagnosis significance for chronic kidney disease (CKD).Methods A total of 81 CKD patients and 73 healthy controls were enrolled.The determinations of serum HE4, carbohydrate antigen ( CA ) 125, alpha fetoprotein ( AFP ), carcinoembryonic antigen(CEA), CA199, CA15-3 and so on were performed by electrochemiluminescence.The results were analyzed by receiver operating characteristic(ROC) curve for the diagnosis of CKD with different stages.Results The levels of serum HE4, CA125, CEA, CA15-3, urea, creatinine and uric acid were significantly higher in CKD patients than those in healthy controls ( P <0.05), while there was no statistical significance for AFP and CA199 between the 2 groups (P >0.05).ROC curve analysis indicated that compared with other parameters, HE4 had a better diagnosis significance for CKD.The area under the curve of HE4 was larger than those of urea, creatinine and uric acid. Additionally, there were statistical significances for serum levels of HE4, CEA, urea, creatinine and uric acid among various stages of CKD(P <0.005).Moreover, the serum levels of these parameters increased with severity of CKD. ROC curve analysis showed that serum HE4, urea, creatinine and uric acid had significant diagnosis significance for staging CKD(CKD4-5), with the area under the curve >0.9.Conclusions Serum HE4 shows an excellent diagnosis significance for CKD.Furthermore, it is closely associated with the severity of CKD.It is significant for judging the stages of CKD.