Page 60 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第41卷第5期
·690 · Journal of Nanjing Medical University（Natural Sciences） 2021年5月

·临床医学·

血清维生素D结合蛋白与慢性肾脏病发生的相关性

彭 慧，李屾森，邢红霞，李汶汶，曹长春 *
南京医科大学附属逸夫医院肾内科，江苏 南京 211166

［摘 要］ 目的：探讨血清维生素D结合蛋白（vitamin D binding protein，DBP）水平与慢性肾脏病（chronic kidney disease，CKD）
发生的相关性。进一步建立CKD的临床风险预测模型，并评估其对CKD的预测效能。方法：选取2020年3—9月肾内科住院
的患者，酶联免疫吸附法检测患者血清DBP水平，分析血清DBP与CKD相关指标的关系，比较高DBP组和低DBP组患者的临
床资料。构建包含DBP的临床风险预测模型并评估其预测CKD发生的效能。结果：与正常对照组和CKD 3期患者相比，CKD 4期
和CKD 5期患者血清DBP水平显著降低。血清DBP与CKD相关临床指标及干预措施具有明显的相关性。与综合临床风险预测
模型A（年龄、性别、尿酸、是否合并瓣膜钙化、高血压、糖尿病）［受试者工作特征曲线的曲线下面积（area under curve，AUC）=
0.917，95% CI：0.849~0.985，P＜0.001］相比，综合临床风险预测模型B（年龄、性别、尿酸、DBP、是否合并瓣膜钙化、高血压、糖尿
病）（AUC=0.942，95% CI：0.894~0.991，P＜0.001）增加了血清DBP这一预测变量，显著改善了预测CKD的受试者工作特征曲线的
AUC和特异度。结论：血清DBP水平与CKD的发生具有相关性。增加血清DBP这一预测变量，可显著改善模型预测CKD的效
能，有助于筛查CKD的高危患者。
［关键词］ 维生素D结合蛋白；慢性肾脏病；肾功能；
［中图分类号］ R692.5 ［文献标志码］ A ［文章编号］ 1007⁃4368（2021）05⁃690⁃06
doi：10.7655/NYDXBNS20210509

The correlation between serum vitamin D binding protein and chronic kidney disease

PENG Hui，LI Shensen，XING Hongxia，LI Wenwen，CAO Changchun *
Department of Nephrology，the Affiliated Sir Run Run Hospital of Nanjing Medical University，Nanjing 211166，China

［Abstract］ Objective：This study aims to explore the relationship between serum vitamin D binding protein（DBP）level and the
occurrence of chronic kidney disease（CKD），further establish a clinical risk prediction model for CKD and evaluate its predictive
power for CKD. Methods：The patients who were hospitalized in the department of nephrology between March 2020 and September
2020 were selected. The serum DBP levels of the patients were detected by the ELISA method. The relationship between serum DBP
and CKD related indicators was anacyzed. And the clinical data of the high DBP group and low DBP group were compared. A clinical
risk prediction model including DBP was construct and its effectiveness was evaluated in predicting the occurrence of CKD. Results：
Compared with the normal control group and CKD stage 3 patients，the serum DBP levels of patients with CKD stage 4 and CKD stage
5 were significantly lower. Serum DBP and CKD related indicators and interventions have obvious correlation. Compared with the
comprehensive clinical risk prediction model A（AUC=0.917，95% CI：0.849~0.985，P＜0.001），the comprehensive clinical risk
prediction model B（AUC=0.942，95% CI：0.894~0.991，P＜0.001）increased the serum DBP as a predictor variable，and significantly
improved the AUC and，specificity for predicting CKD. Conclusion：Serum DBP decreases significantly in CKD 4⁃5 stages，which are
correlated with the occurrence of CKD. The addition of the predictive variable of serum DBP significantly improves the predictive
performance of the model in predicting CKD and helps to screen high⁃risk patients with CKD.
［Key words］ vitamin D binding protein；chronic kidney disease；renal function
［J Nanjing Med Univ，2021，41（05）：690⁃695］

慢性肾脏病（chronic kidney disease，CKD）是由
［基金项目］ 江苏省333高层次人才培养工程（2016II⁃027）
各种原因引起的进行性和不可逆的肾脏结构或功
∗
通信作者（Corresponding author），E⁃mail：caochangchun@njmu.
edu.cn 能异常 ［1-2］ ，患病率高达 8%~16％，已成为全球范围