标题：慢性肾脏病患者血清Cyfra21-1水平的变化及临床意义

      作者：袁腾飞，李艳，彭锐    (武汉大学人民医院检验医学中心，湖北 武汉 430060)

      卷次： 2017年28卷5期

      【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-WhitneyU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。
      【关键词】 慢性肾脏病；细胞角蛋白19片段抗原21-1；尿微量白蛋白；肌酐；尿素
      【中图分类号】 R692 【文献标识码】 A 【文章编号】 1003—6350（2017）05—0771—03

Changes and clinical significance of serum Cyfra21-1 in patients with chronic kidney disease.
YUAN Teng-fei, LIYan, PENG Rui. Clinical Laboratory Medicine Center, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, CHINA
【Abstract】 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 patientswith normal urinary microalbumin (U-MA, normal group) and 84 patients with abnormal U-MA (abnormal group) inRenmin 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 curvesanalysis. 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.
      【Key words】 Chronic kidney disease (CKD); Cytokeratin 19 fragment antigen21-1 (Cyfra21-1); Urinary micro-albumin (U-MA); Creatinine; Urea·论 著·doi:10.3969/j.issn.1003-6350.2017.05.029基金项目：国家自然科学基金(编号：81572069)