慢性肾脏病患者血清Cyfra21-1水平的变化及临床意义

摘要

目的 观察慢性肾脏病患者血清细胞角蛋白19片段抗原21-1(Cyfra21-1)水平的变化并探讨其临床意义.方法 将2016年1~8月到武汉大学人民医院就诊的尿微量白蛋白正常患者114例作为正常组,异常患者84例作为异常组,分别检测两组患者血清Cyfra21-1、肌酐、尿素的含量,采用非参数检验中的Mann-Whitney U检验比较三个指标在两组中的变化,通过ROC曲线比较三个指标对慢性肾脏病的诊断价值.结果 Cyfra21-1、肌酐、尿素三个指标在异常组的血清含量分别为3.6(2.8,4.8)ng/L、96.0(65.8,167.3)μmol/L、7.0(5.1,11.9)mmol/L,显著高于正常组的血清含量2.2(1.7,2.8)ng/L、68.5(59.3,78.0)μmol/L、5.5(4.9,6.5)mmol/L,两组血清含量比较差异均具有统计学意义(P<0.001);血清Cyfra21-1的ROC曲线下面积(AUC=0.838)大于肌酐(AUC=0.718)和尿素(AUC=0.675).结论 血清Cyfra21-1水平的升高可能提示尿微量白蛋白异常,对早期诊断慢性肾脏病有一定价值.%Objective To observe the changes of serum cytokeratin 19 fragment antigen 21-1 (Cyfra21-1) lev-el of patients with chronic kidney disease (CKD), and explore the clinical significance. Methods A total of 114 patients with normal urinary microalbumin (U-MA, normal group) and 84 patients with abnormal U-MA (abnormal group) in Renmin Hospital of Wuhan University from January to August in 2016 were selected. The levels of serum Cyfra21-1, creatinine, urea were detected between two groups, and the changes of three indicators were compared by Mann-Whit-ney U test of the non-parametric test. The diagnostic values of three indicators for CKD were compared by ROC curves analysis. Results The levels of Cyfra21-1, creatinine, urea in abnormal group were respectively 3.6 (2.8,4.8) ng/L, 96.0 (65.8,167.3)μmol/L, 7.0 (5.1,11.9) mmol/L, which were significantly higher than those in normal group of 2.2 (1.7, 2.8) ng/L, 68.5 (59.3,78.0) μmol/L, 5.5 (4.9,6.5) mmol/L, P<0.001. The area under ROC curve of Cyfra21-1 (AUC=0.838) was larger than those of creatinine (AUC=0.718) and urea (AUC=0.675). Conclusion The increase of serum Cy-fra21-1 level may indicate abnormal U-MA, and serum Cyfra21-1 has certain diagnostic value for CKD.