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中华临床医师杂志(电子版)

中华临床医师杂志(电子版) ›› 2022, Vol. 16 ›› Issue (09) : 887 -891. doi: 10.3877/cma.j.issn.1674-0785.2022.09.013

临床研究

联合检测外周血miRNA-21和miRNA-192对慢性肾小球肾炎早期肾功能损害的预测价值
高利超1,†(), 吕强2, 王玉洁1, 张冬梅1, 丁文飞1, 曹灵1, 欧三桃1   
  1. 1. 646000　四川泸州，西南医科大学附属医院肾病内科/四川省肾脏疾病临床医学研究中心
    2. 646000　四川泸州，泸州市人民医院泌尿外科
  • 收稿日期:2022-09-07 出版日期:2022-09-15
  • 通信作者: 高利超

Combined determination of peripheral blood miRNA-21 and miRNA-192 for prediction of early renal function impairment in chronic glomerulonephritis

Lichao Gao1,†(), Qiang Lv2, Yujie Wang1, Dongmei Zhang1, Wenfei Ding1, Ling Cao1, Santao Ou1   

  1. 1. Department of Nephrology, Affiliated Hospital of Southwest Medical University/Sichuan Clinical Research Center for Nephropathy, Sichuan, Luzhou 646000
    2. Department of Urinary Surgery, Luzhou people's Hospital, Sichuan, Luzhou 646000, China
  • Received:2022-09-07 Published:2022-09-15
  • Corresponding author: Lichao Gao
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高利超, 吕强, 王玉洁, 张冬梅, 丁文飞, 曹灵, 欧三桃. 联合检测外周血miRNA-21和miRNA-192对慢性肾小球肾炎早期肾功能损害的预测价值[J/OL]. 中华临床医师杂志(电子版), 2022, 16(09): 887-891.

Lichao Gao, Qiang Lv, Yujie Wang, Dongmei Zhang, Wenfei Ding, Ling Cao, Santao Ou. Combined determination of peripheral blood miRNA-21 and miRNA-192 for prediction of early renal function impairment in chronic glomerulonephritis[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(09): 887-891.

目的

探讨联合检测外周血miRNA-21和miRNA-192对慢性肾小球肾炎早期肾功能损害的预测价值。

方法

选择西南医科大学附属医院2019年1月~2021年6月接受诊治的慢性肾小球肾炎患者76例作为研究组，根据肾小球滤过率（eGFR）分为早期肾功能损害组49例与中期肾功能损害组27例；另选择西南医科大学附属医院2019年1月~2021年6月健康体检者70例作为对照组。所有受试者均制备外周血单个核细胞，采用实时荧光定量PCR（qRT-PCR）法测定miRNA-21和miRNA-192相对表达量。比较各组miRNA-21和miRNA-192相对表达量，肾功能指标变化；采用ROC曲线分析miRNA-21和miRNA-192对肾功能损害的诊断价值；采用Pearson分析miRNA-21和miRNA-192与肾功能损害的相关性。

结果

中期肾功能损害组和早期肾功能损害组外周血单个核细胞miRNA-21和miRNA-192表达高于早期肾功能损害组和对照组，且中期肾功能损害组高于早期肾功能损害组，差异均有统计学意义（P＜0.05）。中期肾功能损害组和早期肾功能损害组血肌酐和尿素氮水平高于早期肾功能损害组和对照组，且中期肾功能损害组高于早期肾功能损害组，差异均有统计学意义（P＜0.05）。通过ROC曲线分析显示，miRNA-21和miRNA-192对早期肾功能损害敏感度分别为90.43%和87.42%，特异度分别为60.61%和51.43%。miRNA-21联合miRNA-192检测对早期肾功能损害敏感度为94.18%，特异度为86.27%。miRNA-21和miRNA-192与肾功能损害呈线性正相关（P＜0.05）。

结论

慢性肾小球肾炎患者肾功能损害越严重miRNA-21和miRNA-192表达越高，miRNA-21联合miRNA-192检测对早期肾功能损害具有一定预测价值。

关键词: 慢性肾小球肾炎, 微小RNA-21, 微小RNA-192, 肾功能, 相关性, 预测价值
Objective

To evaluate the value of peripheral blood miRNA-21 and miRNA-192 in the prediction of early renal function impairment in chronic glomerulonephritis.

Methods

A total of 76 patients who were diagnosed with chronic glomerulonephritis and treated at the Affiliated Hospital of Southwest Medical University from January 2019 to June 2021 were selected as the study group. According to the glomerular filtration rate (eGFR), they were divided into either an early renal impairment group (49 cases) or an intermediate renal impairment group (27 cases). Seventy volunteers who underwent healthy physical examination at the Affiliated Hospital of Southwest Medical University from January 2019 to June 2021 were selected as a control group. Peripheral blood mononuclear cells were collected from all patients to measure the relative expression of miRNA-21 and miRNA-192 by real-time fluorescent quantitative PCR (qRT-PCR). The relative expression levels of miRNA-21 and miRNA-192 as well as the changes in renal function indicators were compared among the groups. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic value of miRNA-21 and miRNA-192 for renal impairment. Pearson correlation was used to analyze the correlation of miRNA-21 and miRNA-192 with renal function impairment.

Results

The expression of miRNA-21 and miRNA-192 in peripheral blood mononuclear cells was significantly higher in the intermediate renal impairment group and the early renal impairment group than in the control group, and in the intermediate renal impairment group than in the early renal impairment group (P＜0.05). Blood creatinine and urea nitrogen levels were significantly higher in the intermediate renal impairment group and the early renal impairment group than in the control group, and in the intermediate renal impairment group than in the early renal impairment group (P＜0.05). ROC curve analysis showed that the sensitivity of miRNA-21 and miRNA-192 for predicting renal damage was 67.44% and 60.98%, and the specificity was 60.61% and 51.43%, respectively. The sensitivity and specificity of miRNA-21 combined with miRNA-192 for predicting early renal impairment were 94.18% and 86.27%, respectively. miRNA-21 and miRNA-192 were positively correlated with renal function impairment (P＜0.05).

Conclusion

The expression of miRNA-21 and miRNA-192 is higher in patients with chronic glomerulonephritis with more severe renal impairment. Combined detection of miRNA-21 and miRNA-192 has appreciated predictive value for early renal impairment.

Key words: Chronic glomerulonephritis, MicroRNA-21, MicroRNA-192, Renal function, Correlation, Predictive value
表1 各组一般资料比较
组别 例数 性别 年龄（岁） 体质指数（kg/m2）
男性 女性
中期肾功能损害组 49 25 24 51.89±8.45 23.12±1.78
早期肾功能损害组 27 15 12 52.72±8.02 23.38±1.70
对照组 70 36 34 51.46±7.08 23.14±1.89
χ2/F值 0.165 0.260 0.206
P值 0.921 0.771 0.814
表2 各组外周血单个核细胞miRNA-21和miRNA-192表达比较（
xˉ
±s）
组别 例数 miRNA-21相对表达量 miRNA-192
中期肾功能损害组 49 5.37±1.48ab 2.86±0.54ab
早期肾功能损害组 27 3.02±1.09a 1.74±0.38a
对照组 70 1.23±0.26 0.92±0.15
F值 251.142 401.842
P值 ＜0.001 ＜0.001
表3 各组肾功能比较（
xˉ
±s）
组别 例数 血肌酐（μmol/L） 尿素氮（mmol/L）
中期肾功能损害组 49 128.97±23.14ab 7.58±0.92ab
早期肾功能损害组 27 95.34±15.42a 6.16±0.78a
对照组 70 64.32±8.98 4.57±0.61
F值 230.829 229.726
P值 ＜0.001 ＜0.001
表4 分析miRNA-21和miRNA-192对早期肾功能损害的预测价值
指标 AUC值 截断值 敏感度（%） 特异度（%） 95%CI
miRNA-21 0.862 2.738 90.43 60.61 0.798~0.927
miRNA-192 0.839 1.493 87.42 51.43 0.773~0.906
二者联合 0.929 - 94.18 86.27 0.887~0.971
图1 ROC曲线分析miRNA-21和miRNA-192对早期肾功能损害的诊断价值
表5 分析miRNA-21和miRNA-192与肾功能损害的相关性
指标 肾功能损害
r值 P值
miRNA-21 0.572 0.003
miRNA-192 0.510 0.009
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