腹膜透析患者透析液中SGLT1、TGF-β1、VEGF水平与腹膜纤维化的关系及应用价值

王超超; 林永强; 陈恬恬; 周莹; 蔡小巧; 林胜芬

doi:10.16766/j.cnki.issn.1674-4152.002325

腹膜透析患者透析液中SGLT1、TGF-β1、VEGF水平与腹膜纤维化的关系及应用价值

doi: 10.16766/j.cnki.issn.1674-4152.002325

1.
温州市中西医结合医院肾内科，浙江温州 325000
2.
温州医科大学附属第一医院肾内科，浙江温州 325000

基金项目:

浙江省基础公益研究计划项目 LQ19H050002

详细信息

通讯作者:
林永强, E-mail：147072058@qq.com

中图分类号: R459.5 R572.2
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- 被引次数: 0
出版历程
- 收稿日期: 2021-08-27
- 网络出版日期: 2022-03-04

The correlation between peritoneal fibrosis and the levels of SGLT1, TGF-β1, and VEGF in peritoneal dialysis patients and its application value

1.
Nephrology Department, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的探讨腹透液中钠-葡萄糖转运体1(SGLT1)、转化生长因子-β1(TGF-β1)、血管内皮生长因子(VEGF)水平与腹膜纤维化的关系及其应用价值。方法选取2012年6月—2021年6月温州市中西医结合医院收治的发生腹膜纤维化的腹膜透析患者25例为研究组，另选取未发生腹膜纤维化的腹膜透析患者35例为对照组，比较2组SGLT1、TGF-β1、VEGF水平，分析SGLT1、TGF-β1、VEGF在腹膜纤维化诊断中的应用价值。结果研究组与对照组比较，SGLT[(128.85±22.58)pg/mL vs.(85.42±15.68)pg/mL], TGF-β1[(432.32±54.18) pg/mL vs. (245.72±32.10) pg/mL], VEGF[(903.25±61.45) ng/mL vs.(612.85±32.10)ng/mL]差异有统计学意义(均P < 0.05)。经ROC曲线分析可知，腹透液中SGLT1、TGF-β1、VEGF联合诊断时可获得最大曲线下面积(AUC)为0.865(95% CI：0.708~0.952)，敏感度、特异度为85.02%、82.14%。结论 SGLT1、TGF-β1、VEGF水平异常升高与腹膜纤维化的发生有密切的关系，可有效预测腹膜纤维化发生情况。
- 腹膜透析 /
- 腹膜纤维化 /
- 钠-葡萄糖转运体1 /
- 转化生长因子-β1 /
- 血管内皮生长因子 /
- 相关性
Abstract: Objective To investigate the correlation between peritoneal fibrosis and the levels of sodium-glucose transporter 1 (SGLT1), transforming growth factor-β1 (TGF-β1), vascular endothelial growth factor (VEGF) and its application value. Methods Twenty-five cases of patients with peritoneal fibrosis on maintenance hemodialysis were selected as study group, and 35 cases of peritoneal dialysis patients without peritoneal fibrosis were selected as the control group in Department of Nephrology, Wenzhou Integrated Traditional Chinese and Western Medicine Hospital from June 2012 to June 2021.The levels of SGLT1, TGF-β1 and VEGF of two groups were compared. The application value of SGLT1, TGF-β1, and VEGF of diagnosis of peritoneal fibrosis were analyzed by diagnosis of peritoneal fibrosis. Results The levels of SGLT [(128.85±22.58) pg/mL vs. (85.42±15.68) pg/mL], TGF-β1 [(432.32±54.18) pg/mL vs. (245.72±32.10) pg/mL], and VEGF [(903.25±61.45) ng/mL vs. (612.85±32.10) ng/mL] were statistically different between the two groups (all P < 0.05). The ROC curve analysis showed that the maximum area under the curve (AUC) were 0.865 (95% CI: 0.708-0.952), and the sensitivity and specificity were 85.02% and 82.14% when the three were diagnosed jointly. Conclusion Abnormally elevated levels of SGLT1, TGF-β1, and VEGF are closely related to the occurrence of peritoneal fibrosis. The levels of SGLT1, TGF-β1, and VEGF can effectively predict the occurrence of peritoneal fibrosis.
- Peritoneal dialysis /
- Peritoneal fibrosis /
- Sodium-glucose transporter 1 /
- Transforming growth factor-β1 /
- Vascular endothelial growth factor /
- Correlation

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图 1 腹透液中SGLT1、TGF-β1、VEGF对腹膜纤维化诊断的ROC曲线图

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表 1 2组终末期肾病患者基线资料比较

组别	例数	性别(男/女，例)	年龄(x±s，岁)	透析时间(x±s，月)	疾病类型(例)				透析前血肌酐(x±s, μmol/L)	透析前血尿素氮(x±s, mmol/L)
组别	例数	性别(男/女，例)	年龄(x±s，岁)	透析时间(x±s，月)	慢性肾小球肾炎	高血压肾损伤	慢性间质性肾炎	其他	透析前血肌酐(x±s, μmol/L)	透析前血尿素氮(x±s, mmol/L)
研究组	25	15/10	45.77±3.98	12.25±3.14	7	8	8	2	521.22±25.36	22.56±3.85
对照组	35	22/13	45.23±4.02	12.72±4.63	10	10	11	4	519.02±24.18	21.40±4.02
统计量		0.050^a	0.515^b	0.440^b	0.232^a				0.340^b	1.121^b
P值		0.822	0.608	0.662	0.972				0.735	0.267
注：^a为χ²值，^b为t值。

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表 2 2组患者超滤量及腹膜透析功能比较(x±s)

组别	例数	超滤量(mL)	D/P	D/D0
研究组	25	362.52±31.02	0.43±0.11	0.55±0.10
对照组	35	516.69±50.26	0.71±0.12	0.40±0.08
t值		-13.582	-9.220	6.449
P值		< 0.001	< 0.001	< 0.001

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表 3 2组患者腹透液中SGLT1、TGF-β1及VEGF水平比较(x±s)

组别	例数	SGLT1 (pg/mL)	TGF-β1 (pg/mL)	VEGF (ng/mL)
研究组	25	128.85±22.58	432.32±54.18	903.25±61.45
对照组	35	85.42±15.68	245.72±32.10	612.85±32.10
t值		8.801	16.709	23.825
P值		< 0.001	< 0.001	< 0.001

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表 4 腹膜透析患者超滤量、腹膜功能与腹透液中SGLT1、TGF-β1、VEGF的关系

项目	相关性	SGLT1	TGF-β1	VEGF
超滤量	r值	-0.512	-0.498	-0.477
	P值	< 0.001	< 0.001	< 0.001
D/Pcr	r值	-0.563	-0.502	-0.457
	P值	< 0.001	< 0.001	< 0.001
D/D0	r值	0.425	0.469	0.523
	P值	< 0.001	< 0.001	< 0.001

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表 5 腹透液中SGLT1、TGF-β1、VEGF对腹膜纤维化的诊断价值

项目	敏感度(%)	特异性(%)	最大约登指数	AUC	95% CI
SGLT1	71.11	70.52	0.535	0.711	0.698~0.892
TGF-β1	74.05	73.02	0.578	0.802	0.743~0.911
VEGF	70.98	75.98	0.529	0.742	0.698~0.904
SGLT1+TGF-β1+VEGF联合诊断	85.02	82.14	0.623	0.865	0.708~0.952

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