标题：sFlt-1在慢性肾小球肾炎中的表达及意义

      作者：李涛，冯晓晨，纪玲玲，肖坤    (大连大学附属中山医院肾内科，辽宁 大连 116001)

      卷次： 2018年29卷15期

      【摘要】 目的 探讨可溶性血管内皮细胞生长因子受体 1 (sFlt-1)在慢性肾小球肾炎中的表达及其临床意义。方法 选取2017年1~12月在大连大学附属中山医院肾内科治疗的慢性肾小球肾炎患者127例，其中早期肾功能损害患者63例，中期肾功能损害43例，晚期肾功能损害21例，同时选取健康志愿者60例作为对照组，检测并比较各组受检者的血清 sFlt-1、尿蛋白、肿瘤坏死因子-α (TNF-α)、白细胞介素-6 (IL-6)、超敏C反应蛋白(hs-CRP)和肾小球滤过率(eGFR)水平。结果 晚期肾功能损害组患者的血sFlt-1和尿蛋白分别为(37.41±7.11) g/L和(7.56±0.81) g/24 h，明显高于对照组[(8.55±2.10) g/L和(1.20±0.70) g/24 h]、早期肾功能损害组[(29.64±5.54) g/L和(2.80±0.61) g/24 h]和中期肾功能损害组[(30.15±6.22) g/L和(4.41±0.70) g/24 h]，差异均有统计学意义(P<0.05)；晚期肾功能损害组患者的血TNF-α、IL-6和 hs-CRP分别为(482.84±60.44) pg/mL、(50.24±22.27) pg/mL和(35.57±12.89) mg/L，明显高于对照组[(82.16±20.03) pg/mL、(13.21±4.15) pg/mL、(7.64±1.41) mg/L]、早期肾功能损害组[(214.64±45.54) pg/mL、(22.84±5.24) pg/mL、(12.24±4.50) mg/L]和中期肾功能损害组[(354.22±52.17) pg/mL、(35.03±10.16) pg/mL、(22.87±9.22) mg/L]，差异均有统计学意义(P<0.05)；血清 sFlt-1与TNF-α、IL-6和 hs-CRP呈正相关(r=0.341、0.322和 0.310，P<0.05)，与肾小球滤过率(eGFR)呈负相关(r=-0.387，P<0.05)，而与尿蛋白无明显关系(r=0.122，P>0.05)。结论 sFlt-1在慢性肾小球肾炎中表达升高，与患者病情程度、炎症因子水平有一定相关性。
      【关键词】 可溶性血管内皮细胞生长因子受体1；慢性肾小球肾炎；炎症因子；病情程度
      【中图分类号】 R692.3+1 【文献标识码】 A 【文章编号】 1003—6350（2018）15—2073—03

Expression and significance of sFlt-1 in chronic glomerulonephritis.
LI Tao, FENG Xiao-chen, JI Ling-ling, XIAOKun. Department of Nephrology, Zhongshan Hospital Affiliated to Dalian University, Dalian 116001, Liaoning, CHINA
【Abstract】 Objective To investigate the expression and significance of soluble fms-like tyrosine kinase recep-tor 1 (sFlt-1) in chronic glomerulonephritis. Methods A total of 127 patients of chronic glomerulonephritis in Depart-ment of Nephrology, Zhongshan Hospital Affiliated to Dalian University from January 2017 to December 2017 were se-lected, including 63 patients of early renal impairment, 43 patients of mid stage renal impairment, and 21 patients of late re-nal impairment. A the same time, 60 healthy volunteers were selected as control group. The serum sFlt-1, urine protein, tu-mor necrosis factor-α(TNF-α), interleukin-6 (IL-6), high sensitive C reactive protein (hs-CRP) and glomerular filtrationrate (eGFR) were detected. Results The sFlt-1 and urine protein in late renal impairment group were (37.41±7.11) g/Land (7.56±0.81) g/24 h, which were significantly higher than (8.55±2.10) g/L and (1.20±0.70) g/24 h in the control group,(29.64±5.54) g/L and (2.80±0.61) g/24 h in early renal impairment group and (30.15±6.22) g/L and (4.41±0.70) g/24 h inmiddle renal impairment group (P<0.05). The TNF-α, IL-6 and hs-CRP in late renal impairment group were (482.84 ±60.44) pg/mL, (50.24±22.27) pg/mL and (35.57±12.89) mg/L, significantly higher than (82.16±20.03) pg/mL, (13.21±4.15) pg/mL, (7.64±1.41) mg/L in the control group, (214.64±45.54) pg/mL, (22.84±5.24) pg/mL, (12.24±4.50) mg/L in ear-ly renal impairment group and (354.22±52.17) pg/mL, (35.03±10.16) pg/mL, (22.87±9.22) mg/L in middle renal impair-ment group (P<0.05). The serum levels of sFlt-1 were positively correlated with TNF-α, IL-6 and hs-CRP (r=0.341,0.322 and 0.310, P<0.05), and was negatively correlated with glomerular filtration rate (eGFR) (r=-0.387, P<0.05), buthad no obvious relationship with urine protein (r=0.122, P>0.05). Conclusion The expression of sFlt-1 is elevated inchronic glomerulonephritis, which is related to the degree of disease and the level of inflammatory factors.
      【Key words】 Soluble fms-like tyrosine kinase receptor 1; Chronic glomerulonephritis; Inflammatory factors; De-gree of disease·论 著·基金项目：辽宁省大连市科技项目(编号：2016-86)