Study On Correlation Between HBP Content And Renal Interstitial Fibrosis In Different Syndrome Types Of G4 And G5 Chronic Kidney Disease

Objective: The contents of heparin-binding protein(HBP)and fibrosis related indexes hyaluronic acid(HA),laminin(LN),type Ⅲ procollagen(PCⅢ)and type Ⅳ collagen(Ⅳ-C)in peripheral blood of patients with chronic kidney disease(CKD)stage G4 and G5 were determined.To observe the content changes of HBP and fibrosis related indexes in different stages of CKD disease and different syndrome types.By analyzing the correlation between HBP and fibrosis related indexes in patients with stage G4 and G5 of CKD,we hope to explore the correlation between the change of HBP content and the renal interstitial fibrosis in stage G4 and G5 of CKD,as well as the change rule of HBP among different syndrome types,so as to provide an auxiliary role for the early diagnosis,efficacy judgment and prognosis observation of CKD.Methods: Patients with stage G4 and G5 CKD were selected as renal failure group and healthy volunteers as control group.Basic clinical data of subjects in each group were collected,glomerular filtration rate(e GFR)was calculated,and TCM syndrome differentiation was performed for renal failure group.Blood samples of patients with CKD stage G4 and G5 and healthy volunteers meeting inclusion criteria were collected.The contents of HBP were determined by biochemical analyzer,and the contents of fibrosis related indexes HA,LN,PCⅢ and Ⅳ-C were determined by chemiluminescence immunoassay,and correlation analysis was conducted between HBP and fibrosis related indexes.SPSS 25.0 and Prism Graphad 8.0were used for data analysis and mapping.Results:1.Comparison of basic data: Compared with healthy control group,there was no significant difference in gender and age in stage G4,stage G5 and different syndrome types of CKD patients(P > 0.05).e GFR was decreased in patients with stage G4,stage G5 and different syndromes(P< 0.05),while serum creatinine,urea,β2 microglobulin and C-reactive protein contents were increased(P < 0.05).2.Fibrosis related indexes: compared with healthy control group,the contents of HA,LN,PCⅢ and Ⅳ-C in renal failure group were increased,and the difference was statistically significant(P < 0.05).The contents of HA,LN,PC Ⅲ and Ⅳ-C in stage G4 and stage G5 renal failure groups were increased,with statistical significance(P < 0.05).Compared with CKD stage G4 renal failure group,the contents of HA,LN,PCⅢ and Ⅳ-C in CKD stage G5 renal failure group were increased,and the difference was statistically significant(P < 0.05).Compared with healthy control group,the contents of HA,LN,PCⅢ and Ⅳ-C were increased in patients with spleen-kidney qi deficiency syndrome,Qi Yin deficiency syndrome and spleen-kidney Yang deficiency syndrome,and the differences were statistically significant(P < 0.05).3.HBP content: Compared with healthy control group,HBP content in renal failure group was increased,and the difference was statistically significant(P < 0.05);The HBP content in stage G4 and stage G5 renal failure groups was increased,and the difference was statistically significant(P < 0.05).Compared with CKD stage G4 renal failure group,HBP content in CKD stage G5 renal failure group was increased,the difference was statistically significant(P < 0.05).Compared with healthy control group,HBP content in patients with spleen and kidney qi deficiency,Qi and Yin deficiency and spleen and kidney Yang deficiency were increased,the difference was statistically significant(P < 0.05).4.Correlation analysis between HBP and renal interstitial fibrosis indexes: Pearson correlation analysis showed that the content of HBP was positively correlated with the content changes of fibrosis related indexes HA,LN,PCⅢ and Ⅳ-C.5.ROC curve analysis results showed that the area under ROC curve(AUC)of HBP for diagnosing stage G4 CKD was 0.800[95%CI(0.696,0.905)],the cut-off value was 15.16ng/ml,the sensitivity was 66.7%,the specificity was 87.5%,and the Yoden index was 0.542.The area under ROC curve(AUC)of HBP for diagnosis of stage G5 of CKD was 0.857 [95%CI(0.788,0.927)],the cut-off value was 22.23ng/ml,the sensitivity was 66.2%,the specificity was 90.6%,and the Yoden index was 0.568.conclusion:1.The content of HBP and fibrosis-related indexes in stage G4 and G5 patients with CKD increased,and the increase of HBP and fibrosis-related indexes became more significant with the progression of the disease;HBP and fibrosis related indicators can be used as auxiliary indicators for the detection of CKD.2.The contents of HBP and fibrosis-related indexes increased in patients with spleen and kidney qi deficiency syndrome,Qi and Yin deficiency syndrome and spleen and kidney Yang deficiency syndrome.HBP and fibrosis-related indexes can be used as auxiliary diagnostic indexes of CRF in traditional Chinese medicine.3.HBP content in peripheral blood of patients with CKD stage G4 and G5 is positively correlated with the changes of fibrosis related indexes HA,LN,PCⅢ and Ⅳ-C.4.HBP has high sensitivity and specificity in the diagnosis of stage G4 and G5 of CKD,and has auxiliary diagnostic significance in evaluating the severity of RIF and judging the progression of CKD.