尿可溶性CD163水平对儿童原发性肾病综合征激素治疗反应的预测价值  

Predictive value of the urine soluble CD163 levels for the glucocorticoid treatment response in children with the primary nephrotic syndrome

作　　者：胡海燕[1] 韦懿[1] 胡勤 HU Haiyan;WEI Yi;HU Qin(Zigong Maternal and Child Health Hospital of Sichuan Province,Zigong 643000,China)

机构地区：[1]四川省自贡市妇幼保健院,四川自贡643000

出　　处：《长春中医药大学学报》2022年第4期435-438,共4页Journal of Changchun University of Chinese Medicine

基　　金：2019年自贡市科学技术局第二批市级重点科技计划项目(2019YLSF35)。

摘　　要：目的分析尿sCD163水平与儿童原发性肾病综合征糖皮质激素治疗反应之间的关系,并探索其对糖皮质激素治疗反应的预测价值。方法选择肾病综合征患儿120例。根据患儿对糖皮质激素治疗的反应,分为激素治疗有反应组(有反应组)70例及激素治疗无反应组(无反应组)50例。使用酶联免疫吸附法测定尿液sCD163水平,并使用尿肌酐浓度进行校正;使用Logistic回归分析患儿一般资料、组织病理学资料及临床资料与糖皮质激素治疗反应的关系;ROC曲线分析预测因素对糖皮质激素治疗反应的预测效能。结果2组病理学资料比较差异明显(P<0.001);有反应组血红蛋白、hs-CRP及sCD163水平均显著高于无反组(P<0.05);多因素Logistic结果显示,与尿sCD163在低分位(<3.4 ng·mg^(+))的患儿比较,尿sCD163在中分位(3.4~8.5 ng·mg^(+))患儿对激素治疗有反应的OR为3.66(95%CI,1.76~5.22,P<0.001),尿sCD163在高分位(≥8.5 ng·mg^(+))患儿对激素治疗有反应的OR为8.35(95%CI,5.92~13.81,P<0.001);临床模型预测糖皮质激素治疗反应的效能为0.7,单独使用尿sCD163预测糖皮质激素治疗反应的效能为0.74,在临床模型的基础上联合尿sCD163后,预测糖皮质激素治疗反应的效能为0.81。结论尿sCD163与儿童原发性肾病综合征糖皮质激素治疗反应有显著相关性,且可提升临床模型对糖皮质激素治疗反应的预测能力。Objective To analyze the relationship between the urine sCD163 levels and the glucocorticoid treatment responses in children with the primary nephrotic syndrome,and to explore its predictive value for the glucocorticoid treatment response.Methods A total of 120 children with the nephrotic syndrome were enrolled as the research subjects.According to their responses to the glucocorticoid treatment,the subjects were divided into a hormone treatment response group(referred to as response group,n=70 cases)and a hormone treatment non-response group(referred to as non-response group,n=50 cases).Their urine sCD163 levels were measured by the enzyme-linked immunosorbent assay(ELISA)and corrected by the urine creatinine concentration levels.The Logistic regression was used to analyze the relationship between the children’s general data,histopathological data,clinical data and their glucocorticoid treatment responses.The ROC curve was used to analyze the predictive efficacy of predictive factors for glucocorticoid treatment responses.Results The difference in the pathological data between the two groups was statistically significant(P<0.001),and the levels of hemoglobin,hs-CRP and urine sCD163 in the response group were significantly higher than those in the non-response group(P<0.05).The multivariate Logistic results showed that,compared with the children with urine sCD163 in the low quantile(<3.4 ng·mg^(+)),the OR value of the children with urine sCD163 in the middle quantile(3.4 to 8.5 ng·mg^(+))responding to the hormone treatment was 3.66(95%CI,1.76-5.22,P<0.001),while the OR value of the children with urine sCD163 in the high quantile(≥8.5 ng·mg^(+))responding to the hormone treatment was 8.35(95%CI,5.92-13.81,P<0.001).The efficacy of the clinical model in predicting the glucocorticoid treatment response was 0.7,and the efficacy of using urine sCD163 alone was 0.74,while the efficacy of the combined urine sCD163 and the clinical model in predicting the glucocorticoid treatment response was 0.81.Conclusion The ur

关 键 词：尿可溶性CD163 儿童 原发性肾病综合征 糖皮质激素 治疗反应 

分 类 号：R72[医药卫生—儿科]