肾综合征出血热患者血清可溶性CD23、肝素结合蛋白表达与其病情严重程度和预后的关系The relationship between the expression of serum soluble CD23 and heparin binding protein in patients with hemorrhagic fever with renal syndrome and its severity and prognosis
杜虹;王平忠;胡海峰;王晓艳;姜泓;李璟;连建奇;王临旭;
摘要(Abstract):
目的探究肾综合征出血热(hemorrhagic fever with renal syndrome,HFRS)患者血清可溶性CD23(soluble CD23,sCD23)、肝素结合蛋白(heparin binding protein,HBP)表达与其病情严重程度和预后的关系。方法纳入2012年9月至2016年1月中国人民解放军空军军医大学第二附属医院收治的123例HFRS患者为研究对象,依据临床分型标准,将其分为轻型组(21例)、中型组(32例)、重型组(30例)和危重型组(40例)。将同期于该院体检的健康者30例纳入对照组。采用双抗体夹心酶联免疫吸附测定检测HFRS患者急性期、恢复期和健康者的血清sCD23、HBP表达水平。观察血清sCD23、HBP在不同分型患者中的表达变化及其与对照组的差异。采用Pearson相关分析探讨HFRS患者血清sCD23、HBP与常规实验室指标的关系。采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析sCD23、HBP和常规实验室指标对HFRS患者预后的预测效能。结果各型HFRS患者急性期血清sCD23、HBP表达水平均显著高于同型恢复期和对照组(均P<0.01),且血清sCD23、HBP表达水平均随着疾病加重而逐渐升高(均P<0.01);各型HFRS患者恢复期血清sCD23、HBP表达均显著高于对照组(均P<0.01),但各型间血清sCD23、HBP表达水平比较差异均无统计学意义(均P>0.05);Pearson相关分析结果显示,HFRS患者血清sCD23、HBP表达与活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、纤维蛋白原(fibrinogen,Fib)、白细胞(white blood cell,WBC)、血小板(platelet,PLT)、血红蛋白、血细胞比容、白蛋白(albumin,ALB)、血尿素氮、尿酸、谷丙转氨酶和谷草转氨酶(aspartate aminotransferase,AST)均具有相关性(均P<0.01),其中与APTT、Fib、WBC、PLT、ALB、AST相关性较强(均|r_s|>0.50,均P<0.01)。ROC曲线显示,血清sCD23、HBP预测HFRS患者预后的曲线下面积分别为0.799(95%CI:1.415~9.408,P<0.01)、0.882(95%CI:1.440~14.627,P<0.01),二者联合的诊断效能最高。结论血清sCD23、HBP的异常表达与HFRS患者病情严重程度和预后密切相关,可作为疾病早期预测指标。
关键词(KeyWords): 肾综合征出血热;可溶性CD23;肝素结合蛋白;预后
基金项目(Foundation): 国家科技重大专项课题(2017ZX10204401-002-005);; 院创新发展基金临床面上项目(2019LCYJ011);院创新发展基金临床重点项目(2019LCYJ002)
作者(Authors): 杜虹;王平忠;胡海峰;王晓艳;姜泓;李璟;连建奇;王临旭;
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