[1]程 莉,章晓良,吴福杉,等.血清正五聚蛋白3、三叶因子3水平对维持性血液透析患者预后转归的预测价值[J].陕西医学杂志,2023,52(7):814-818.[doi:DOI:10.3969/j.issn.1000-7377.2023.07.008]
　CHENG Li,ZHANG Xiaoliang,WU Fushan,et al.Predictive value of serum PTX3 and TFF3 levels for prognosis of patients with maintenance hemodialysis[J].,2023,52(7):814-818.[doi:DOI:10.3969/j.issn.1000-7377.2023.07.008]
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血清正五聚蛋白3、三叶因子3水平对维持性血液透析患者预后转归的预测价值
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年7期
页码:
814-818
栏目:
临床研究
出版日期:
2023-07-05

文章信息/Info

Title:
Predictive value of serum PTX3 and TFF3 levels for prognosis of patients with maintenance hemodialysis
作者:
程 莉; 章晓良; 吴福杉; 程 义
(解放军联勤保障部队第九一〇医院,福建 泉州 362000)
Author(s):
CHENG Li; ZHANG Xiaoliang; WU Fushan; CHENG Yi
(The 910th Hospital of the Joint Logistic Support Force of PLA,Quanzhou 362000,China)
关键词:
维持性血液透析;  三叶因子3;  正五聚蛋白3;  联合检测;  预后
Keywords:
Maintenance hemodialysis;  Trefoil factor 3;  Pentraxin 3;  Combined detection;  Prognosis
分类号:
R 692
DOI:
DOI:10.3969/j.issn.1000-7377.2023.07.008
文献标志码:
A
摘要:
目的:探讨正五聚蛋白3(PTX3)、三叶因子3(TFF3)在维持性血液透析患者血清中的表达及对预后的预测价值。方法:选取收治的133例维持性血液透析患者为研究组,根据患者随访2年内的生存状况分为死亡组(24例)和存活组(109例),同期选取健康体检的志愿者130例为对照组。收集各组一般资料,比较血清中PTX3、TFF3表达水平; 利用受试者工作特征(ROC)曲线评价PTX3、TFF3水平对维持性血液透析患者预后不良的预测价值; Logistic回归分析影响维持性血液透析患者预后不良发生的因素。结果:研究组患者血清TFF3、PTX3表达水平均高于对照组,差异具有统计学意义(均P<0.05); 死亡组患者血清TFF3、PTX3表达水平高于存活组(均P<0.05); 死亡组患者营养不良占比及超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、血小板与淋巴细胞比值(PLR)均高于存活组,残肾滤过率低于存活组,比较差异具有统计学意义(均P<0.05); ROC曲线结果显示,血清PTX3、TFF3水平预测维持性血液透析患者预后不良的曲线下面积(AUC)分别为0.895、0.889,截断值分别为42.09 μg/L、2.55 ng/ml,对应的敏感度分别为83.33%、75.00%,特异度分别为84.40%、89.91%,二者联合预测的AUC为0.951,敏感度为95.83%,特异度为78.90%; 多因素Logistic回归分析结果显示,TFF3、PTX3、残肾滤过率、TNF-α、hs-CRP、IL-6、PLR均是影响维持性血液透析患者预后不良发生的独立危险因素(均P<0.05)。结论:维持性血液透析患者血清中TFF3、PTX3表达均上升,二者均为影响维持性血液透析患者预后不良发生的因素,联合检测对维持性血液透析患者预后不良有较高的预测价值。
Abstract:
Objective:To investigate the serum levels of pentraxin 3(PTX3)and trefoil factor 3(TFF3)in maintenance hemodialysis(MHD)patients and their predictive value for prognosis.Methods:A total of 133 patients with MHD were selected as the study group,and the patients were divided into death group(24 cases)and survival group(109 cases)according to their survival status within 2 years of follow-up.At the same time,130 volunteers who had physical examination were selected as the control group.General data were collected and the expression levels of PTX3 and TFF3 in serum of each group were compared.The predictive value of PTX3 and TFF3 levels on poor prognosis of MHD patients was evaluated by ROC curve.Logistic regression analysis was used to analyze the factors influencing the poor prognosis of MHD patients.Results:The levels of serum TFF3 and PTX3 in the study group were higher than those in the control group(all P<0.05).The levels of serum TFF3 and PTX3 in death group were higher than those in survival group(all P<0.05).The proportion of malnutrition,hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and platelet to lymphocyte ratio(PLR)in the death group were higher than those in the survival group,and the filtering rate of residual kidney was lower than that in the survival group(all P<0.05).ROC curve results showed that the area under the curve(AUC)of serum PTX3 and TFF3 levels in predicting poor prognosis in MHD patients was 0.895 and 0.889 respectively,the cut-off value was 42.09 μg/L and 2.55 ng/ml respectively,the corresponding sensitivity was 83.33% and 75.00% respectively,and the specificity was 84.40% and 89.91% respectively,the AUC predicted by the two methods combination was 0.951,the sensitivity was 95.83%,and the specificity was 78.90%.Multi-factor Logistic regression analysis showed that TFF3,PTX3,residual renal filtration rate,TNF-α,hs-CRP,IL-6,and PLR were all independent risk factors for the occurrence of poor prognosis in MHD patients(all P<0.05).Conclusion:The expression of TFF3 and PTX3 in the serum of MHD patients increases,both of which are factors affecting the poor prognosis of MHD patients.The combined detection has a high predictive value for the poor prognosis of MHD patients.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助项目(81760016)
更新日期/Last Update: 2023-07-05