[1]宋 强,李永钢.慢性肾病Ⅲ～Ⅴ期患者血清Klotho，OTA 和Bcl-3 表达水平与疾病预后的相关性研究[J].现代检验医学杂志,2023,38(04):173-179.[doi:10.3969/j.issn.1671-7414.2023.04.032]
　SONG Qiang,LI Yonggang.Correlation of Serum Klotho, OTA and Bcl-3 Expression Levels and Disease Prognosis in Patients with Chronic Kidney Disease Stage Ⅲ～Ⅴ[J].Journal of Modern Laboratory Medicine,2023,38(04):173-179.[doi:10.3969/j.issn.1671-7414.2023.04.032]
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慢性肾病Ⅲ～Ⅴ期患者血清Klotho，OTA 和Bcl-3 表达水平与疾病预后的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年04期
页码:
173-179
栏目:
检验与临床
出版日期:
2023-07-15

文章信息/Info

Title:
Correlation of Serum Klotho, OTA and Bcl-3 Expression Levels and Disease Prognosis in Patients with Chronic Kidney Disease Stage Ⅲ～Ⅴ
文章编号:
1671-7414（2023）04-173-07
作者:
宋 强; 李永钢
（内蒙古包钢医院检验科，内蒙古包头 014010）
Author(s):
SONG Qiang;  LI Yonggang
（Department of Clinical Laboratory，Inner Mongolia Baogang Hospital, Inner Mongolia Baotou 014010, China）
关键词:
慢性肾病; Klotho; 赭曲霉毒素A; B 细胞淋巴瘤因子3
分类号:
R692；R392.11
DOI:
10.3969/j.issn.1671-7414.2023.04.032
文献标志码:
A
摘要:
目的　研究慢性肾病(chronic kidney disease，CKD) Ⅲ～Ⅴ期患者血清Klotho，赭曲霉毒素A（OTA）和B 细胞淋巴瘤因子3(Bcl-3) 水平，分析三者的临床预后价值。方法　选取内蒙古包钢医院2018 年1 月～ 2019 年1 月期间收治的原发性CKD Ⅲ～Ⅴ期患者118 例为研究对象（CKD 组），以同期健康查体的健康者60 例为对照组。应用酶联免疫吸附实验检测血清Klotho，OTA 和Bcl-3 表达水平。相关性分析采用Pearson 相关分析。Kaplan-Meier 生存分析不同血清Klotho，OTA 和Bcl-3 水平患者肾脏存活率的差异。单因素及多因素COX 回归分析影响CKD Ⅲ～Ⅴ期患者肾脏结局事件发生的因素。结果　CKD 组患者血清Klotho（2.54±0.39 mg/L）低于对照组（8.24±1.30 mg/L），血清OTA（2.11±0.40 mg/L），Bcl-3（81.25±13.67 pmol/L）高于对照组（0.40±0.13 mg/L，48.14±10.28 pmol/L），差异均有统计学意义（t=43.996，32.111，16.526，均P<0.05）。不同CKD 分期患者血清Klotho，OTA 和Bcl-3 水平比较，差异均具有统计学意义（F=206.071，48.544，60.466，均P<0.05）。CKD 组患者血清Klotho 与估计肾小球滤过率(eGFR）呈显著正相关（r=0.627，P<0.05），血清OTA，Bcl-3 与eGFR 呈显著负相关（r=-0.537，-0.489，均P<0.05），血清Klotho 表达与OTA，Bcl-3 表达呈显著负相关（r=-0.689，-0.703，均P<0.05）。低Klotho 组肾脏存活率[44.83%（26/58）]低于高Klotho 组[75.00%（45/60）]，差异具有统计学意义（Log rank χ2=6.988，P<0.05）；高OTA 组肾脏存活率[40.68%（24/59）] 低于低OTA 组[79.66%（47/59）]，差异具有统计学意义（Log rank χ2=7.247，P<0.05）；高Bcl-3 组肾脏存活率[46.67%（28/60）] 低于低Bcl-3 组[74.14%（43/58）]，差异具有统计学意义（Log rank χ2=7.198，P<0.05）。24h尿蛋白量（OR=1.602，95%CI=1.268 ～ 2.022），eGFR（OR=0.628，95%CI=0.493 ～ 0.799），血清Klotho（OR=0.577，95%CI=0.416 ～ 0.800），OTA（OR=2.061，95%CI=1.922 ～ 2.279） 和Bcl-3（OR=1.809，95%CI=1.218 ～ 2.688） 是影响CKD Ⅲ～Ⅴ期患者肾脏结局事件发生的独立因素。结论　CKD Ⅲ～Ⅴ期患者血清Klotho 降低，OTA，Bcl-3 水平升高，三者血清水平与患者肾功能状况有关，有助于评估CKD Ⅲ～Ⅴ期患者的预后。
Abstract:
Objective　To study the expression levels of serum Klotho，Ochratoxin A (OTA) and B-cell lymphoma factor 3 (Bcl- 3) in patients with chronic kidney disease (CKD) staging Ⅲ ～Ⅴ and assess their prognostic value. Methods　A total of 118 primary CKD patients staging Ⅲ～Ⅴ admitted to Inner Mongolia Baogang Hospital from January 2018 to January 2019 were selected as the research subjects（CKD group）, and 60 healthy subjects who underwent physical examination during the same period were selected as the control group. The expression levels of serum Klotho, OTA and Bcl-3 were detected by enzymelinked immunosorbent assay. The relationship between indictors were analyzed by Pearson correlation analysis. The differences in renal survival between patients with different serum Klotho, OTA and Bcl-3 expression levels were analyzed by Kaplan-Meier survival analysis. Univariate and multivariate COX regression analysis was used to analyze the factors influencing the renal outcome of CKD patients with stage Ⅲ～Ⅴ . Results　In CKD group, serum Klotho(2.54 ± 0.39 mg/L) was lower than that in control group（8.24 ± 1.30 mg/L）, serum OTA (2.11 ± 0.40 mg/L) and Bcl-3 (81.25 ± 13.67 pmol/L ) were higher than those in control group（0.40 ± 0.13 mg/L，48.14 ± 10.28 pmol/L）, and the differences were statistically significant ( t=43.996，32.111，16.526，all P<0.05). The difference of serum Klotho, OTA and Bcl-3 levels in patients with different CKD stages was statistically significant (F=206.071, 48.544, 60.466, all P<0.05).In CKD group，serum Klotho was significantly positively correlated with eGFR (r=0.627, P<0.05), and serum OTA and Bcl-3 were negatively correlated with eGFR (r=-0.537, -0.489, all P<0.05). Serum Klotho was significantly negatively correlated with the expression of OTA and Bcl- 3 (r=-0.689, -0.703, P<0.05). The renal survival rate [44.83% (26/58)] in the low Klothogroup was significantly lower than that in the high Klotho group[75.00% (45/60)] (Log rank χ2=6.988, P<0.05). The renal survival rate in the high OTA group [40.68% (24/59)] was significantly lower than that in the low OTA group[79.66% (47/59)] (Log rank χ2=7.247, P<0.05). The renal survival rate of high Bcl-3 group [46.67% (28/60)] was significantly lower than that of low Bcl-3 group[74.14% (43/58)](Log rank χ2=7.198, P<0.05)，the differences were statistically significant，respectively. 24h urine protein (OR=1.602， 95%CI=1.268 ～ 2.022),eGFR (OR=0.628，95%CI=0.493 ～ 0.799), serum Klotho(OR=0.577，95% CI=0.416 ～ 0.800), OTA (OR=2.061，95%CI=1.922 ～ 2.279), and Bcl-3 (OR=1.809，95% CI=1.218 ～ 2.688) were independent factors affecting the renal outcome of CKD stage Ⅲ ～ Ⅴ patients. Conclusion　In patients with CKD stage Ⅲ ～ Ⅴ , serum Klothois decreased, while levels of OTA and Bcl-3 increased, which were related to the patient’s renal function and are helpful to evaluate the prognosis of CKD stage Ⅲ～Ⅴ patients.

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备注/Memo

备注/Memo:
基金项目：内蒙古自治区科学技术厅资助项目（912013J0624）：血清可溶性Klotho 与慢性肾脏病患者肾功能及预后的关系研究。
作者简介：宋强（1989-），男，硕士研究生，主管检验师，研究方向：免疫学、分子生物学，E-mail：songqiang0025@163.com。
通讯作者：李永钢（1974-），男，本科，副主任技师，研究方向：临床血液体液学、分子生物学。
更新日期/Last Update: 2023-07-15