血清sTNF-R1、IGFBP-2、CFH对狼疮性肾炎患儿疾病活动度及预后的评估价值  

Evaluation value of serum sTNF-R1,IGFBP-2,CFH on disease activity and prognosis of children with lupus nephritis

作　　者：焦书丽 赵荣香 陈竹 史洋溢 任丹 JIAO Shuli;ZHAO Rongxiang;CHEN Zhu;SHI Yangyi;REN Dan(Department of Pediatrics,Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Mianyang,Sichuan 621000,China)

机构地区：[1]电子科技大学医学院附属绵阳医院·绵阳市中心医院儿科,四川绵阳621000

出　　处：《国际检验医学杂志》2022年第8期945-949,共5页International Journal of Laboratory Medicine

基　　金：湖北陈孝平科技发展基金会项目(CXPJJH12000003-202022)。

摘　　要：目的探讨狼疮性肾炎(LN)患儿血清可溶性肿瘤坏死因子受体1(sTNF-R1)、胰岛素样生长因子结合蛋白-2(IGFBP-2)、补体因子H(CFH)表达水平,分析其与疾病活动度关系及对LN患儿预后的预测价值。方法选取2016年1月至2018年7月在该院儿科接受治疗的LN患儿100例(LN组)作为研究对象。另选取该院体检健康儿童50例作为对照组。两组采用酶联免疫吸附试验检测血清sTNF-R1、IGFBP-2、CFH水平并比较其差异。采用Pearson相关性分析血清sTNF-R1、IGFBP-2、CFH与临床指标的相关性。随访2年,根据LN患儿预后情况,将其分为预后良好组(n=72)和预后不良组(n=28)。绘制受试者工作特征曲线(ROC曲线)分析血清sTNF-R1、IGFBP-2、CFH对LN患儿临床预后的评估价值。结果LN组血清sTNF-R1、IGFBP-2、CFH水平与对照组相比,差异有统计学意义(P<0.05)。LN患儿活动组血清sTNF-R1、IGFBP-2、CFH水平与非活动组相比,差异有统计学意义(P<0.05)。Pearson相关性分析示,血清sTNF-R1、IGFBP-2与24 h尿总蛋白(24 h-UTP)、超敏C-反应蛋白(hs-CRP)、系统性红斑狼疮疾病活动度(SLEDAI)评分呈正相关,血清CFH与24 h-UTP、hs-CRP、抗双链DNA抗体、SLEDAI评分呈负相关(P<0.05)。LN患儿预后不良组血清sTNF-R1、IGFBP-2水平高于预后良好组,血清CFH水平低于预后良好组,差异有统计学意义(P<0.05)。ROC曲线结果示,血清sTNF-R1、IGFBP-2、CFH及三者联合检测预测LN患儿不良预后的AUC分别为0.785、0.769、0.850、0.901。结论LN患儿血清sTNF-R1、IGFBP-2升高及血清CFH降低,其血清水平与患儿疾病活动度及临床预后密切相关,联合检测血清sTNF-R1、IGFBP-2、CFH对预测LN患儿临床预后具有较高临床价值。Objective To investigate the serum soluble tumor necrosis factor receptor 1(sTNF-R1),insulin-like growth factor binding protein-2(IGFBP-2)and complement factor H(CFH)expression levels in children with lupus nephritis(LN)and analyze its relationship with disease activity and its predictive value for the prognosis of children with LN.Methods A total of 100 children with LN(LN group)who received treatment in the department of pediatrics of a hospital from January 2016 to July 2018 were selected as the study subjects.Another 50 healthy children were selected as the control group.The enzyme-linked immunosorbent assay was used to detect the differences in serum sTNF-R1,IGFBP-2,and CFH levels.Pearson correlation was used to analyze the correlation between serum sTNF-R1,IGFBP-2,CFH and clinical indicators.Followed up for 2 years,according to the prognosis of LN children,they were divided into a good prognosis group(n=72)and a poor prognosis group(n=28).ROC curve was used to analyze the evaluation value of serum sTNF-R1,IGFBP-2,CFH on the clinical prognosis of children with LN.Results The serum levels of sTNF-R1,IGFBP-2,and CFH in the LN group were significantly different from those in the control group(P<0.05).The levels of serum sTNF-R1,IGFBP-2,CFH in the active group of children with LN were significantly different from those in the inactive group(P<0.05).Pearson correlation analysis showed that serum sTNF-R1 and IGFBP-2 were positively correlated with 24 h-UTP,hs-CRP,SLEDAI scores,and serum CFH was negatively correlated with 24 h-UTP,hs-CRP,anti-dsDNA,and SLEDAI scores(P<0.05).The levels of serum sTNF-R1 and IGFBP-2 in the poor prognosis group of LN children were higher than those in the good prognosis group,and the serum CFH level was lower than that in the good prognosis group,and the difference was statistically significant(P<0.05).ROC curve results showed that the AUC of serum sTNF-R1,IGFBP-2,CFH and the combined detection of the three to predict the poor prognosis of children with LN were 0.785,0.769,0.850 and 0.

关 键 词：可溶性肿瘤坏死因子受体1 胰岛素样生长因子结合蛋白-2 补体因子H 狼疮性肾炎 

分 类 号：R593.242[医药卫生—内科学]