特发性膜性肾病患者血清增殖诱导配体水平与临床病理指标及预后的关系  

Relationship between serum proliferation-inducing ligand levels and clinicopathological indicators and prognosis in patients with idiopathic membranous nephropathy

作　　者：林倩[1] 朱义芳[1] 刘婷莉 杨清[1] 马玉华[1] 黄潇苇[1] LIN Qian;ZHU Yifang;LIU Tingli;YANG Qing;MA Yuhua;HUANG Xiaowei(Department of Clinical Laboratory,Chengdu Third People′s Hospital,Chengdu,Sichuan 610000,China)

机构地区：[1]四川省成都市第三人民医院临床医学检验部,四川成都610000

出　　处：《国际检验医学杂志》2022年第9期1115-1119,共5页International Journal of Laboratory Medicine

基　　金：四川省卫生和计划生育委员会科研课题(18PG128)。

摘　　要：目的探讨特发性膜性肾病(IMN)患者血清增殖诱导配体(APRIL)水平与临床病理指标及预后的关系。方法选取2018年1月至2020年1月于该院肾脏内科住院,并行肾活检术的188例肾病综合征患者为研究对象,根据诊断标准分为IMN组72例,继发性膜性肾病(SMN)组12例和非膜性肾病(non-MN)组104例,比较3组一般资料及血清APRIL水平。采用受试者工作特征(ROC)曲线分析APRIL在诊断IMN中的临床价值。根据IMN组APRIL水平平均值将IMN组分为高表达组38例和低表达组34例,比较两组临床病理特征。对IMN组进行随访,采用生存曲线分析评估不同APRIL水平对IMN患者预后的影响。结果与SMN组和non-MN组比较,IMN组患者24 h尿蛋白、三酰甘油、总胆固醇、抗PLA2R抗体及血清APRIL水平升高,血肌酐、免疫球蛋白G、免疫球蛋白A水平降低(P<0.05)。ROC曲线分析结果显示,当APRIL最佳截断值为13.782μg/L时,诊断IMN的曲线下面积(AUC)为0.875。APRIL高表达组24 h尿蛋白、抗PLA2R抗体、免疫球蛋白G(IgG)染色强度均高于APRIL低表达组(P<0.05)。生存曲线分析结果显示,与高表达组比较,低表达组累积缓解率更高(P<0.05)。结论血清APRIL水平与IMN患者病情严重程度相关,检测APRIL水平可作为辅助诊断IMN的生物标志物之一。患者APRIL水平过高时可能影响预后。Objective To investigate the relationship between serum proliferation-inducing ligand(APRIL)level and clinicopathological indicators and prognosis in patients with idiopathic membranous nephropathy(IMN).Methods A total of 188 patients with nephrotic syndrome who were hospitalized in the Department of Nephrology and undergone renal biopsy in the hospital from January 2018 to January 2020 were selected as the research objects.According to the diagnostic criteria,they were divided into idiopathic membranous nephropathy group(IMN group)and secondary Membranous nephropathy(SMN)group and non-membranous nephropathy(non-MN)group,the general information and serum APRIL levels of the three groups were compared.The receiver operating characteristic(ROC)curve was used to analyze the clinical value of APRIL in the diagnosis of IMN.According to the average APRIL level of the IMN group,the IMN group was divided into high expression group(38 cases)and low expression group(34 cases),and the clinicopathological characteristics of the two groups were compared.The IMN group was followed up,and survival analysis was used to evaluate the impact of different APRIL levels on the prognosis of IMN patients.Results Compared with SMN group and non-MN group,patients in IMN group had higher levels of 24 h urine protein,triacylglycerol,total cholesterol,anti-PLA2R antibody and serum APRIL,while serum creatinine,immunoglobulin G,and immunoglobulin A levels Lower(P<0.05).The ROC curve results showed that when the APRIL cut-off value was 13.782μg/L,the area under the curve(AUC)for diagnosing IMN was 0.875.The staining intensity of 24 h urine protein,anti-PLA2R antibody,and immunoglobulin G(IgG)in the APRIL high expression group was higher than that in the APRIL low expression group(P<0.05).The results of survival curve analysis showed that compared with the high expression group,the low expression group had a higher cumulative remission rate(P<0.05).Conclusion Serum APRIL level is correlated with the severity of IMN patients.The detection of APR

关 键 词：特发性膜性肾病 增殖诱导配体 预后 

分 类 号：R446.6[医药卫生—诊断学]