和肽素水平对大鼠心肾综合征的早期预测价值

目的:研究和肽素(CPP)水平对部分肾切除术(SNX)合并心肌梗死(MI)大鼠心肾综合征(CRS)的预测价值。方法:60只雄性SD大鼠采用SNX+MI建立CRS模型,随机分成空白对照(Con)组、SNX组、MI组和CRS组,造模后1~5周检测大鼠血清与尿液中CPP浓度的变化及血液动力学、血压与肾功能的水平。采用受试者工作特征(ROC)曲线评价CPP对大鼠发生CRS的预测价值。结果:与Con组比,CRS组大鼠在造模后9 d的左心室收缩压(LVSP)显著降低(P0.05),左心室舒张末压(LVEDP)显著升高(P0.05),而血压在各时点的差异无统计学显著性;CRS组大鼠的血尿素氮(BUN)和尿肌酐(UCr)在1周和3周均显著升高(P0.05)。与Con组比,CRS组在造模后1、3和5周血清中的CPP显著升高(P0.05),造模后3周尿液中的CPP显著升高(P0.05);在造模后1和3周血清中脑钠肽(BNP)显著升高(P0.05),造模后5周尿液中BNP显著升高(P0.05);CRS组在造模后1周血清和尿液中CPP与BNP和BUN无相关性。ROC曲线分析显示,血清CPP在1周时预测CRS的曲线下面积(AUC)为0.908(95%CI为0.789~1.028),以56.59 ng/L为阈值,其诊断敏感度为87.5%,特异性为80.0%。结论:SNX+MI合并术式能建立心肾共损的CRS大鼠模型,血清CPP可以作为CRS早期预测较为敏感和特异的生物标志物。

Level of copeptin for early prediction of cardiorenal syndrome in rats

AIM: To study the value of copeptin (CPP) level for the prediction of cardiorenal syndrome (CRS) in the rats with subtotal nephrectomy (SNX) combined with myocardial infarction (MI).METHODS: Male SD rats (n=60) were divided into blank control group (Con group), renal failure group (SNX group), heart failure group (MI group) and heart failure+renal failure group (CRS group). The concentrations of CPP in the serum and urine, hemodynamic indexes, blood pressure and renal function indexes were measured 1~5 weeks after modeling. The predictive value of CPP for CRS in the rats was evaluated by the receiver operating characteristic (ROC) curve.RESULTS: Compared with Con group, left ventricular systolic pressure (LVSP) at 9 d in CRS group was significantly decreased (P<0.05), left ventricular end-diastolic pressure (LVEDP) at 9 d in CRS group was significantly increased (P<0.05), and the difference of blood pressure at each time point was not statistically significant. The levels of blood urea nitrogen (BUN) and urinary creatinine (UCr) in CRS group were significantly increased at 1 and 3 weeks (P<0.05). Compared with Con group, serum CPP level was significantly increased at 1, 3 and 5 weeks (P<0.05), and urine CPP level was significantly increased at 3 weeks in CRS group. Serum brain natriuretic peptide (BNP) level was significantly increased at 1 and 3 weeks, while urine BNP level was significantly increased at 5 weeks after modeling in CRS group (P<0.05). No correlation between serum or urine CPP and BNP or BUN levels at 1 week in CRS group was observed. The results of ROC curve analysis indicated that the area under the curve (AUC) of serum CPP was 0.908 (95% CI:0.789~1.028), and the cut-off value was 56.59 ng/L (sensitivity 0.875, specificity 0.800).CONCLUSION: The combination of SNX and MI establishes a CRS rat model with both heart and kidney injury, and serum CPP can be used as a sensitive and specific biomarker for early prediction of CRS.