Chitinase-3-like protein 1 combined with estimated glomerular filtration rate in evaluating the curative effect of interventional therapy for atherosclerotic renal artery stenosis

doi:10.3969/j.issn.1673-8640.2018.011.006

Abstract

Abstract:

Objective To evaluate the roles of chitinase-3-like protein 1（CHI3L1） and estimated glomerular filtration rate（eGFR） in evaluating the curative effect of interventional therapy for atherosclerotic renal artery stenosis（ARAS）. Methods The clinical data of 78 patients with ARAS treated by percutaneous renal artery stenting （PRAS） were collected. According to the results of CHI3L1 and eGFR at 1 month after treatment,the patients were classified into group A （CHI3L1 and eGFR were abnormal,20 cases）,group B（CHI3L1 or eGFR was normal,28 cases） and group C（CHI3L1 and eGFR were normal,30 cases）. The baseline data （sex,age,the duration of hypertension,the type of antihypertensive drugs,the location of renal artery stenosis,smoking and chronic diseases）,blood pressure in follow-up period,1 month before treatment and 1 month after treatment,urinary albumin/creatinine ratio（ACR）,serum creatinine（SCr） level and the degree of renal artery stenosis were compared among the 3 groups. The incidence rates of adverse events and survival rates among the 3 groups in follow-up period were recorded. Results There was no statistical significance among the 3 groups for the baseline data and follow-up period（P>0.05）,and the CHI3L1 levels of group A,B and C decreased in turn（P<0.05）. There was no statistical significance in blood pressure,urinary ACR,SCr level and the degree of renal artery stenosis among the 3 groups before treatment （P>0.05）. After treatment,diastolic blood pressure,systolic blood pressure,urinary ACR,SCr level,CHI3L1 level and the degree of renal artery stenosis decreased gradually （P<0.05）. The incidence rates of adverse events in group A,B and C were 23.33%,17.86% and 6.67%,respectively,and the 1-year survival rates after treatment were 75.00%,92.86% and 100.00%,respectively（P<0.05）. The sensitivity and specificity of CHI3L1 combined determination with eGFR in the evaluation of interventional therapy were 95.65% and 55.56%,which were higher than those of eGFR determination （94.20% and 11.11%）. Conclusions CHI3L1 combined determination with eGFR is of value in evaluating the curative effect of interventional therapy and the prognosis of ARAS.

Key words: Chitinase-3-like protein 1, Estimated glomerular filtration rate, Atherosclerotic renal artery stenosis, Interventional therapy

CLC Number:

R446.1

QIN Chuntang. Chitinase-3-like protein 1 combined with estimated glomerular filtration rate in evaluating the curative effect of interventional therapy for atherosclerotic renal artery stenosis[J]. Laboratory Medicine, 2018, 33(11): 991-996.

Figures/Tables 6

References 24

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组别	例数	性别		年龄（岁）	高血压病程（年）	肾动脉狭窄（例）
组别	例数	男	女	年龄（岁）	高血压病程（年）	单侧		双侧
A组	20	10	10	61.86±6.42	7.41±3.72	9		11
B组	28	15	10	63.16±8.50	8.12±4.13	11		17
C组	30	19	11	60.43±7.11	8.02±4.17	15		15
组别	长期吸烟史（例）			合并症（例）			随访时间（月）		CHI3L1（μg/L）
组别	长期吸烟史（例）			糖尿病	冠心病	高血脂症	随访时间（月）		CHI3L1（μg/L）
A组	9			6	7	5	20.86±6.42		42.36±6.33
B组	9			10	7	7	20.96±8.50		36.23±6.02^*
C组	15			9	6	6	21.22±8.10		32.18±5.65^*#

组别	例数	性别		年龄（岁）	高血压病程（年）	肾动脉狭窄（例）
组别	例数	男	女	年龄（岁）	高血压病程（年）	单侧		双侧
A组	20	10	10	61.86±6.42	7.41±3.72	9		11
B组	28	15	10	63.16±8.50	8.12±4.13	11		17
C组	30	19	11	60.43±7.11	8.02±4.17	15		15
组别	长期吸烟史（例）			合并症（例）			随访时间（月）		CHI3L1（μg/L）
组别	长期吸烟史（例）			糖尿病	冠心病	高血脂症	随访时间（月）		CHI3L1（μg/L）
A组	9			6	7	5	20.86±6.42		42.36±6.33
B组	9			10	7	7	20.96±8.50		36.23±6.02^*
C组	15			9	6	6	21.22±8.10		32.18±5.65^*#

组别	例数	舒张压（kPa）	收缩压（kPa）	尿ACR （mg/g）	SCr （μmol/L）	肾动脉狭窄程度（%）	CHI3L1 （μg/L）
A组	20
术前		11.40±1.40	21.32±2.40	100.7（82.0~136.0）^*	99.54±12.20	80.12±9.70	42.36±6.33
术后		10.72±0.89^*	19.88±1.90^*	57.0（19.8~84.4）	93.13±9.21^*	55.07±7.28^*	38.26±6.00^*
B组	28
术前		11.36±1.25	20.96±2.38	172.0（138.0~238.0）^*#	99.16±12.02	80.40±10.41	36.23±6.02^#
术后		10.12±0.81^*#	18.79±1.72^*#	48.3（19.8~88.4）	88.03±8.84^*#	50.93±7.01^*#	33.16±5.26^*#
C组	30
术前		11.39±1.36	21.14±2.39	171.3（138.9~239.0）^*△	98.36±11.91	80.73±10.79	32.18±5.65^#△
术后		9.56±0.78^*△	17.67±1.48^*△	42.6（19.2~103.4）	82.22±8.86^*△	43.75±6.65^*△	26.68±5.07^*△#

组别	例数	舒张压（kPa）	收缩压（kPa）	尿ACR （mg/g）	SCr （μmol/L）	肾动脉狭窄程度（%）	CHI3L1 （μg/L）
A组	20
术前		11.40±1.40	21.32±2.40	100.7（82.0~136.0）^*	99.54±12.20	80.12±9.70	42.36±6.33
术后		10.72±0.89^*	19.88±1.90^*	57.0（19.8~84.4）	93.13±9.21^*	55.07±7.28^*	38.26±6.00^*
B组	28
术前		11.36±1.25	20.96±2.38	172.0（138.0~238.0）^*#	99.16±12.02	80.40±10.41	36.23±6.02^#
术后		10.12±0.81^*#	18.79±1.72^*#	48.3（19.8~88.4）	88.03±8.84^*#	50.93±7.01^*#	33.16±5.26^*#
C组	30
术前		11.39±1.36	21.14±2.39	171.3（138.9~239.0）^*△	98.36±11.91	80.73±10.79	32.18±5.65^#△
术后		9.56±0.78^*△	17.67±1.48^*△	42.6（19.2~103.4）	82.22±8.86^*△	43.75±6.65^*△	26.68±5.07^*△#

分组	例数	不良事件						1年生存
分组	例数	高血压	肾脏萎缩	肾脏衰竭	心肌梗死	脑梗死	合计	1年生存
A组	20	3（15.00）	1（5.00）	1（5.00）	1（5.00）	2（10.00）	7（23.33）	15（75.00）
B组	28	3（10.71）	1（3.57）	1（3.57）	0（0.00）	0（0.00）	5（17.86）	26（92.86）
C组	30	1（3.33）	1（3.33）	0（0.00）	0（0.00）	0（0.00）	2（6.67）	30（100.00）
χ²值							6.54	7.20
P值							<0.05	<0.05