• 成都市第三人民醫(yī)院腎內(nèi)科（成都，610031）;

【摘要】 目的  探討細(xì)胞角蛋白19的可溶性片段CYFRA21-1在慢性腎臟病（chronic kidney disease，CKD）患者血清中的表達(dá)及其臨床意義。 方法  2008年10月-2009年4月隨機(jī)選取45例CKD患者，根據(jù)肌酐清除率（creatinine clearance rate，Ccr）的大小分為Ccr lt;15 mL/min組（23例）和Ccr gt;15 mL/min組（22例），并以正常體檢者（10例）為正常對照組，肺鱗癌患者（10例）為陽性對照組，每位參與研究者取血后采用酶聯(lián)免疫吸附法測定血清CYFRA21-1的濃度。 結(jié)果  正常對照組、陽性對照組、Ccr gt;15 mL/min組和Ccr lt;15 mL/min組的血清CFRA21-1濃度分別為（1.720±0.535）、（21.010±11.809）、（3.310±1.569）和（5.090±1.306） ng/mL。與正常對照組比較，其余3組的CYFRA21-1濃度均顯著升高，有統(tǒng)計(jì)學(xué)意義（P lt;0.05），且均值大于正常參考值（0~3.3 ng/mL）；Ccr gt;15 mL/min組和Ccr lt;15 mL/min組的CFRA21-1濃度顯著低于陽性對照組，有統(tǒng)計(jì)學(xué)意義（P lt;0.05）；兩個(gè)實(shí)驗(yàn)組間隨著Ccr的降低，CYFRA21-1濃度升高，有統(tǒng)計(jì)學(xué)意義（P lt;0.05）。 結(jié)論  CKD患者血清CYFRA21-1水平的升高與腎功能減退存在一定關(guān)系，可將其作為臨床上預(yù)測腎臟纖維化程度的指標(biāo)。
【Abstract】 Objective  To discuss the clinical Between significance of cytokeratin 19 fragment (CYFRA21-1) in patients with chronic kidney disease (CKD). Methods  From October 2008 to April 2009, 45 inpatients were randomly selected and assigned into three groups according to creatinine clearance rate (Ccr) level: Ccr lt;15 mL/min, Ccr gt;15 mL/min. Ten healthy volunteers were chosen as control group, and other 10 patients with lung squamous cell carcinoma as positive control group. ELISA was used to measure the serum concentration of CYFRA21-1. Results  Compared with control group, the serum concentration of CYFRA21-1 in CKD groups and positive control group was elevated (P lt;0.05). As the Ccr decreased, the serum concentration of CYFRA21-1 was elevated (P lt;0.05) in two CKD groups. Conclusion  Serum concentration of CYFRA21-1 in CKD patients has a relationship with the renal function decrease, and may be used as an indication of renal interstitial fibrosis (RIF).

引用本文： 程弓,陳澤君,全大勇,王平. 慢性腎臟病患者CYFRA21-1的表達(dá)分析. 華西醫(yī)學(xué), 2010, 25(9): 1607-1608. doi: 復(fù)制

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  3. 3. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification[J]. Am J Kidney Dis, 2002, 39(2 Suppl 1): S1-S266. Comment in: Am J Kidney Dis, 2008, 51(2): 346.
  4. 4. Sun SS, Hsieh JF, Tsai SC, et al. Cytokeratin fragment 19 and squamous cell carcinoma antigen for early prediction of recurrence of squamous cell lung carcinoma[J]. Am J Clin Oncol, 2000, 23(3): 241-243.
  5. 5. Kashiwabara K, Kishi K, Nakamura H, et al. Mechanism of increased serum cytokeratin 19 fragment levels in patients with diabetic nephropathy as a model of chronic renal failure[J]. Intern Med, 1998, 37(11): 917-921.
  6. 6. Takeuchi S, Saitoh H, Yoshida K, et al. The clinical usefulness of urinary determinations of cytokeratin 19 fragment (CYFRA 21-1) in urothelial tumor[J]. Hinyokika Kiyo, 1995, 41(8): 589-592.
  7. 7. Romero S, Fernández C, Arriero JM, et al. CEA, CA15-3 and CYFRA21-1 in serum and pleural fluid of patients with pleural effusions[J]. Eur Respir J, 1996, 9(1): 17-23.
  8. 8. Yang J, Liu Y. Dissection of key events in tubular epithelial to myofibroblast transition and its implications in renal interstitial fibrosis[J]. Am J Pathol, 2001, 159(4): 1465-1475.