摘要
目的分析特发性膜性肾病(IMN)患者血清抗磷脂酶A2受体(PLA2R)抗体滴度、C-型凝集素样结构域1(CTLD1)水平及二者预测预后的价值。方法选取2022年5月至2023年5月绵阳四O四医院154例IMN患者为研究对象,治疗12个月后评估预后情况,根据预后情况分为预后不良组和预后良好组。比较2组入院时基线资料、血清PLA2R抗体滴度、CTLD1水平。采用Pearson相关分析入院时血清PLA2R抗体滴度与CTLD1水平的相关性。采用多因素Logistic回归分析IMN患者预后不良的影响因素。采用受试者工作特征(ROC)曲线分析血清PLA2R抗体滴度、CTLD1水平预测IMN患者预后不良的价值。结果154例IMN患者的预后不良率为25.97%。预后不良组入院时估算肾小球滤过率(eGFR)低于预后良好组,24 h尿蛋白(24 h-pro)、血清PLA2R抗体滴度、CTLD1水平高于预后良好组,差异均有统计学意义(P<0.05);预后不良组、预后良好组入院时血清PLA2R抗体滴度均与CTLD1水平呈正相关(r=0.572、0.564,P<0.05);入院时eGFR、24 h-pro、血清PLA2R抗体滴度、CTLD1水平均为IMN患者预后不良的影响因素(P<0.05);入院时血清PLA2R抗体滴度、CTLD1单独预测IMN患者预后不良的曲线下面积(AUC)分别为0.761、0.768,与eGFR、24 h-pro的AUC比较,差异均无统计学意义(P>0.05);血清PLA2R抗体滴度联合CTLD1预测IMN患者预后不良的AUC为0.886,大于eGFR、24 h-pro、血清PLA2R抗体滴度、CTLD1单独预测的AUC(P<0.05)。结论血清PLA2R抗体滴度、CTLD1水平与IMN患者预后密切相关,联合检测在预测患者预后不良方面具有良好应用价值。
Objective To analyze the serum antiphospholipase A2 receptor(PLA2R)antibody titer and Ctype lectin-like domain 1(CTLD1)level in patients with idiopathic membranous nephropathy(IMN),as well as their predictive value of prognosis.Methods A total of 154 patients with IMN in Mianyang 404 Hospital were selected from May 2022 to May 2023,and their prognosis was evaluated after 12 months of treatment,and they were divided into poor prognosis group and good prognosis group according to their prognosis.General information,serum PLA2R antibody titer and CTLD1 level at admission were compared between the two groups.Pearson correlation analysis was used to investigate the correlation between serum PLA2R antibody titer and CTLD1 level at admission.Multivariate Logistic regression was used to analyze the factors influencing the poor prognosis of IMN patients.Receiver operating characteristic(ROC)curve was used to analyze the value of serum PLA2R antibody titer and CTLD1 level in predicting poor prognosis in IMN patients.Results The rate of poor prognosis among the 154 patients with IMN in this study was 25.97%.The estimated glomerular filtration rate(eGFR)at admission in the poor prognosis group was lower than that in the good prognosis group,and the 24-h urinary protein(24 h-pro),serum PLA2R antibody titer and CTLD1 level were higher than those in the good prognosis group(P<0.05).The serum PLA2R antibody titer at admission in both the poor prognosis group and the good prognosis group correlated positively with the level of CTLD1(r=0.572,0.564,P<0.05).At admission,eGFR,24-h pro,serum PLA2R antibody titer and CTLD1 level were all factors influencing the poor prognosis of IMN patients(P<0.05).The area under the curve(AUC)of serum PLA2R antibody titer and CTLD1 alone for predicting poor prognosis in IMN patients at admission were 0.761 and 0.768 respectively,which showed no significant difference compared with the AUC of eGFR and 24 h-pro(P>0.05).The AUC of serum PLA2R antibody titer combined with CTLD1 for predicting poor prognosis in IMN patients was 0.886,which was larger than the AUC predicted by eGFR,24 h-pro,serum PLA2R antibody titer and CTLD1 alone(P<0.05).Conclusion The serum PLA2R antibody titer and CTLD1 level are closely related to the prognosis of IMN patients,and combined detection has good application value in predicting poor prognosis.
作者
王虹英
肖雨歆
王强
肖胜
简讯
杨乔岚
WANG Hongying;XIAO Yuxin;WANG Qiang;XIAO Sheng;JIAN Xun;YANG Qiaolan(Department of Nephrology,North Sichuan Medical College,Mianyang,Sichuan 621000,China;Department of Nephrology,Mianyang 404 Hospital/Mianyang First People's Hospital,Mianyang,Sichuan 621000,China;Department of Nephrology,Jinniu Hospital,Sichuan Provincial People's Hospital/Jinniu District People's Hospital,Chengdu,Sichuan 610000,China)
出处
《检验医学与临床》
2025年第14期1953-1957,1963,共6页
Laboratory Medicine and Clinic
基金
四川省绵阳市卫生健康委员会2021年科研课题补助项目(202106)。
关键词
特发性膜性肾病
抗磷脂酶A2受体抗体
C-型凝集素样结构域1
预后
预测
idiopathic membranous nephropathy
antiphospholipase A2 receptor antibody
C-type lectin-like domain 1
prognosis
predictive
作者简介
王虹英,女,医师,主要从事慢性肾脏病管理研究;通信作者:简讯,E-mail:191437574@qq.com。
