The test of KIM-1, Cys C and β2-MG to assess the early renal damage in OSAHS patients and its clinical significance
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摘要: 目的:检测肾脏损伤因子-1(KIM-1)、胱抑素C(Cys C)及β2微球蛋白(β2-MG)在OSAHS患者中的表达水平,探索其对OSAHS患者早期肾功能损伤的评估及临床意义。方法:选取PSG监测OSAHS阳性的患者80例作为实验组,同时以OSAHS阴性者15例作为对照组,均在清晨抽取空腹静脉血检测Cys C的水平,留取中段晨尿离心后用双抗体夹心酶联免疫吸附法(ELISA)检测KIM-1的水平,所有实验数据均用SPSS13.0统计软件进行分析和比较。结果:①根据AHI变化分组检测结果:KIM-1在中度及重度患者尿中的水平高于正常人(P<0.01),Cys C、β2-MG在重度患者血中的水平均高于正常人(P<0.01),在轻度、中度、重度3组间的表达,组间两两比较,KIM-1在3组间差异均有统计学意义,Cys C、β2-MG均只在重度患者血中的水平高于轻度、中度患者(P<0.01)。②根据LSaO2变化分组检测结果:KIM-1、Cys C、β2-MG在重度组中的水平均高于正常对照组(P<0.01),在轻、中、重度3组间的表达,组间两两比较,在重度组中的水平均高于轻、中度组中的水平(P<0.01)。③KIM-1、Cys C及β2-MG组间以及与AHI之间均呈正相关(P<0.01)。④在OSAHS患者中,KIM-1、Cys C及β2-MG均与LSaO2呈负相关(P<0.01)。结论:KIM-1可以作为监测OSAHS患者早期肾功能损伤的灵敏指标,并且按照AHI分组时评价OSAHS患者早期肾功能损伤的价值优于按照LSaO2分组。Abstract: Objective:The purpose of this study was to investigate the expression level of kidney injury molecule l (KIM-1), cystatin C(Cys C) and β2-microglobulin(β2-MG) in patients with obstructive sleep apnea and hypopnea syndrome (OSAHS) disease, and to assess the clinical significance among these factors in OSAHS patients with early renal injury.Method:Total 80 OSAHS patients diagnosed by polysomnogram(PSG) in the sleep disorder lab were selected as experimental group and 15 healthy adults who were normal in PSG examinations were selected as control group. Measure the levels of Cys C, β2-MG in fasting venous blood in the morning and detecte the level of KIM-1 in midpiece urine after centrifugation by enzyme-linked immunolsorbent assay (ELISA). All data were analyzed by the SPSS13.0 statistical software.Result:①According to AHI grouping:the average levels of uric KIM-1 in the moderate and severe patients were higher than healthy control group(P<0.01). The serum levels of Cys C and β2-MG in severe OSAHS patients were higher than healthy control group(P<0.01). Besides, the difference of the average levels of uric KIM-1 among the mild, moderate and severe OSAHS patients was statistically significant(P<0.01) and the serum level of Cys C and β2-MG only in severe OSAHS patients were higher than mild and moderate OSAHS patients(P<0.01).②According to LSaO2 grouping:the average level of KIM-1, Cys C and β2-MG in the severe group were higher than normal control group(P<0.01). Besides, the average level of KIM-1, Cys C and β2-MG in severe group were higher than mild and moderate groups(P<0.01). ③KIM-1, Cys C and β2-MG were positive correlated with each other and AHI (P<0.01). ④KIM-1, Cys C and β2-MG were negative correlated with LSaO2 (P<0.01).Conclusion:The urine level of KIM-1 might be a sensitive indicator in OSAHS patients with early renal damage. It was better to evaluate renal injury by AHI grouping than LSaO2 in OSAHS patients.
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