狼疮性肾炎患者血清补体C9、凝溶胶蛋白与肾功能及疾病转归的关系  

Relationship between serum complement C9,gelsolin and renal function,disease outcome in patients with lupus nephritis

作　　者：张福 韩碧翠 刘贞妮 ZHANG Fu;HAN Bicui;LIU Zhenni(Department of Renal Rheumatology,Wenchang People′s Hospital,Wenchang,Hainan 571300,China)

机构地区：[1]文昌市人民医院肾内风湿科,海南文昌571300

出　　处：《国际检验医学杂志》2024年第9期1106-1109,1115,共5页International Journal of Laboratory Medicine

基　　金：海南省自然科学基金青年基金项目(819QN347)。

摘　　要：目的分析狼疮性肾炎患者血清补体C9、凝溶胶蛋白(GSN)与肾功能及疾病转归的关系。方法选择2020年7月至2022年4月该院收治的101例狼疮性肾炎患者作为研究对象,根据入院时肾小球滤过率(eGFR)分为肾功能正常组[eGFR≥90 mL/(min·1.73 m^(2)),n=57]和肾功能不全组[eGFR<90 mL/(min·1.73 m^(2)),n=44]。所有患者入院后24 h内检测血清补体C9、GSN,并进行组间比较。采用Pearson相关法分析血清补体C9、GSN与狼疮性肾炎患者肾功能的关系。随访后根据疾病转归情况分为恶化组(n=35)和好转组(n=66)。采用受试者工作特征(ROC)曲线评估血清补体C9、GSN对狼疮性肾炎患者疾病转归的预测价值,多因素Logistic回归分析探讨狼疮性肾炎患者疾病转归的相关因素。结果肾功能正常组患者血清补体C9低于肾功能不全组,血清GSN水平高于肾功能不全组,差异有统计学意义(P<0.05)。Pearson相关性分析发现,血清补体C9与狼疮性肾炎患者的肾功能呈显著负相关(r=-0.554,P<0.001),血清GSN与狼疮性肾炎患者的肾功能呈显著正相关(r=0.448,P<0.001)。恶化组血清补体C9水平高于好转组,GSN水平低于好转组,差异有统计学意义(P<0.05)。ROC曲线分析显示,血清补体C9预测狼疮性肾炎疾病转归的曲线下面积(AUC)为0.826(95%CI:0.776~0.876);血清GSN预测狼疮性肾炎疾病转归的AUC为0.830(95%CI:0.780~0.880);二者联合检测预测狼疮性肾炎疾病转归的AUC为0.905(95%CI:0.855~0.955)。多因素Logistic回归分析发现,血清补体C9(OR=3.480,95%CI:1.983~6.108)、GSN(OR=4.225,95%CI:2.050~8.708)及eGFR(OR=3.762,95%CI:2.069~6.840)、24 h尿蛋白(OR=1.939,95%CI:1.442~2.642)均为影响狼疮性肾炎疾病转归的危险因素(P<0.05)。结论血清补体C9、GSN水平变化与狼疮性肾炎肾功能、疾病转归密切相关,且均可作为评估狼疮性肾炎患者疾病转归的有效指标,二者联合检测具有更好的预测价值。Objective To explore the relationship between serum complement C9,gelsolin(GSN)and renal function and disease outcome in patients with lupus nephritis.Methods A total of 101 patients with lupus nephritis admitted to the hospital from July 2020 to April 2022 were selected as the study objects,and according to the glomerular filtration rate(eGFR),they were divided into normal renal function group[eGFR≥90 mL/(min·1.73 m^(2)),n=57]and incomplete renal function group[eGFR<90 mL/(min·1.73 m^(2)),n=44].Serum complement C9 and GSN were detected in all patients within 24 h after admission,and comparison between groups was conducted.Pearson correlation method was used to analyze the relationship between serum complement C9,GSN and renal function in patients with lupus nephritis.After follow-up,patients were divided into worsening group(n=35)and improving group(n=66)according to the disease outcome.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum complement C9 and GSN for disease outcome in patients with lupus nephritis.The related factors for disease outcome in patients with lupus nephritis were explored by multivariate Logistic regression analysis.Results Serum complement C9 in normal renal function group was lower than that in incomplete renal function group,and serum GSN level was higher than that in incomplete renal function group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that serum complement C9 was significantly negatively correlated with renal function in lupus nephritis patients(r=-0.554,P<0.001),and serum GSN was significantly positively correlated with renal function in lupus nephritis patients(r=0.448,P<0.001).The serum complement C9 level in the worsening group was higher than that in the improving group,and the GSN level was lower than that in the improving group,and the differences were statistically significant(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum complement C9 in pre

关 键 词：狼疮性肾炎 补体C9 凝溶胶蛋白 肾功能 疾病转归 

分 类 号：R593.242[医药卫生—内科学] R446.1[医药卫生—临床医学]