2023 年第 4 期 第 18 卷

血清肝细胞生长因子和富亮氨酸α2糖蛋白1水平与子痫前期及急性肾损伤的相关性分析

Correlation analysis of serum hepatocyte growth factor and leucine-rich alpha-2 glycoprotein 1 levels with preeclampsia and acute kidney injury

作者：李引弟1宋渊丽1李雪峰2

英文作者：Li Yindi1 Song Yuanli1 Li Xuefeng2

单位：1延安大学附属医院产科，延安716000；2空军军医大学第二附属医院妇产科，西安710038

英文单位：1Department of Obstetrics Yan′an University Affiliated Hospital Yan′an 716000 China; 2Department of Obstetrics and Gynecology the Second Affiliated Hospital of Air Force Medical University Xi′an 710038 China

关键词：妊娠期高血压；先兆子痫；急性肾损伤；肝细胞生长因子；富亮氨酸α2糖蛋白1

英文关键词：Gestationalhypertension;Preeclampsia;Acutekidneyinjury;Hepatocytegrowthfactor;Leucine-richalpha-2glycoprotein1

• 摘要：

• 目的 探讨血清肝细胞生长因子（HGF）、富亮氨酸α2糖蛋白1（LRG1）水平与子痫前期及急性肾损伤（AKI）的相关性。方法 选取延安大学附属医院2020年6月至2022年6月收治的110例子痫前期患者（PE组）和121例妊娠期高血压患者（GH组），另选择51例健康孕妇为对照组。记录受试者血清HGF、LRG1、血尿素氮、血肌酐水平及估算肾小球滤过率（eGFR）。根据是否发生AKI将子痫前期患者分为AKI组和非AKI组。采用Pearson相关性方法分析血清HGF、LRG1与肾功能指标的相关性，多因素Logistic回归模型分析子痫前期患者AKI的影响因素。采用受试者工作特征（ROC）曲线分析血清HGF、LRG1对子痫前期患者发生AKI的预测价值。结果 PE组和GH组血清LRG1、血尿素氮、血肌酐水平均高于对照组、且PE组均高于GH组，PE组和GH组血清HGF水平、eGFR均低于对照组、且PE组均低于GH组，差异均有统计学意义（均P＜0.05）。110例子痫前期患者中49例发生AKI（AKI组）、61例未发生AKI（非AKI组）。子痫前期患者血清HGF水平与血尿素氮、血肌酐呈负相关（r=-0.420，P＜0.001；r=-0.398，P=0.001），与eGFR呈正相关（r=0.547，P＜0.001）；血清LRG1水平与血尿素氮、血肌酐呈正相关（r=0.416，P＜0.001；r=0.502，P＜0.001），与eGFR呈负相关（r=-0.685，P＜0.001）。多因素Logistic回归分析结果显示，重度子痫前期、LRG1是子痫前期患者发生AKI的独立危险因素（均P＜0.05），HGF是独立保护因素（P＜0.05）。ROC曲线分析结果显示，HGF、LRG1联合预测的曲线下面积大于二者单独预测（Z=4.339、4.942，均P＜0.001）。结论 子痫前期患者血清HGF水平降低、LRG1水平升高，低水平HGF和高水平LRG1与患者发生AKI有关。

• Objective To investigate the correlation of serum hepatocyte growth factor (HGF) and leucine-rich alpha-2 glycoprotein 1 (LRG1) levels with preeclampsia (PE) and acute kidney injury (AKI). Methods From June 2020 to June 2022, 110 patients with PE (PE group), 121 patients with gestational hypertension (GH group), and 51 healthy pregnant women (control group) were selected from Yan′an University Affiliated Hospital. The levels of serum HGF, LRG1, blood urea nitrogen（BUN）, serum creatinine (Scr), and the estimated glomerular filtration rate (eGFR) of subjects were recorded. According to whether AKI occurred, PE patients were divided into AKI group and non-AKI group. Pearson correlation analysis was used to analyze the correlation of serum HGF and LRG1 with kidney function indexes. Multivariate Logistic regression model was used to analyze the influencing factors of AKI in PE patients. Receiver operating characteristic (ROC) curve was used to analyze the value of serum HGF and LRG1 for predicting AKI in PE patients. Results The serum levels of LRG1, BUN and Scr in PE group and GH group were higher than those in control group, and the levels in PE group were higher than those in GH group; the levels of serum HGF and eGFR in PE group and GH group were lower than those in control group, and the levels in PE group were lower than those in GH group(all P<0.05). Among 110 PE patients, 49 cases had AKI (AKI group) and 61 cases had no AKI (non-AKI group). Serum HGF level was negatively correlated with BUN and Scr in PE patients (r=-0.420，P＜0.001；r=-0.398，P=0.001), and it was positively correlated with eGFR (r=0.547，P＜0.001); serum LRG1 level was positively correlated with BUN and Scr (r=0.416，P＜0.001；r=0.502，P＜0.001), and it was negatively correlated with eGFR (r=-0.685，P＜0.001). Multivariate Logistic regression analysis results showed that severe PE and LRG1 were independent risk factors for AKI in PE patients (both P<0.05), and HGF was an independent protective factor (P<0.05). ROC curve analysis results showed that the area under the curve of HGF and LRG1 in combination was larger than that of HGF and LRG1 alone for predicting AKI in PE patients (Z=4.339, 4.942, both P<0.001). Conclusions  The serum HGF level decreases and the LRG1 level increases in PE patients. Low level of HGF and high level of LRG1 are correlated to the occurrence of AKI in PE patients.