纤维蛋白原与特发性膜性肾病患者肾小管萎缩/间质纤维化的关系及预测价值  

Relationship Between Fibrinogen and Renal Tubular Atrophy/Interstitial Fibrosis in Patients with Idiopathic Membranous Nephropathy and the Predictive Value

作　　者：黄亚楠 张庆红[1] 史秀岩[1] 胡雪梅 HUANG Ya-nan;ZHANG Qing-hong;SHI Xiu-yan;HU Xue-mei(Department of Nephrology,Taihe Hospital,Hubei University of Medicine,Shiyan,Hubei 442000,China)

机构地区：[1]湖北医药学院附属太和医院肾病内科,湖北十堰442000

出　　处：《湖北医药学院学报》2024年第3期282-286,294,共6页Journal of Hubei University of Medicine

摘　　要：目的:探讨纤维蛋白原(FIB)与特发性膜性肾病(IMN)患者肾小管萎缩/间质纤维化(TA/IF)之间的关系及预测价值。方法:本研究纳入2018年9月至2023年12月在湖北医药学院附属太和医院肾病内科经肾活检证实的171例IMN患者,收集肾活检时的各项临床参数。根据肾穿刺活检前的FIB水平将患者分为正常FIB组(FIB≤4 g/L)和高FIB组(FIB>4 g/L)。根据TA/IF的程度,患者分为T1组(无/轻度,n=67)、T2组(中度,n=56)、T3组(重度,n=48)。通过有序Logistic回归对TA/IF程度的影响因素进行分析。采用受试者工作特征(ROC)曲线分析FIB对TA/IF程度的预测价值。结果:与正常FIB组相比,高FIB组中、重度TA/IF的比例明显较高;T2和T3组患者的临床表现更差。年龄、FIB、TG是影响IMN患者TA/IF程度的独立危险因素;FIB对中重度TA/IF预测价值较好。结论:合理控制FIB水平可能减少IMN患者中重度TA/IF发生的风险。Objective To explore the relationship between fibrinogen(FIB)and renal tubular atrophy/interstitial fibrosis(TA/IF)in patients with idiopathic membranous nephropathy(IMN),and to evaluate the predictive value.Methods A to⁃tal of 171 IMN patients,diagnosed by renal biopsy at Taihe hospital,affiliated with Hubei University of Medicine from Sep⁃tember 2018 to December 2023 were included,and their clinical parameters were collected at the time of their biopsy.Based on FIB before biopsy,the patients were divided into a normal FIB group(FIB≤4 g/L)and a high FIB group(FIB>4 g/L).Depending on the severity of TA/IF,the patients were further categorized into three groups:T1(none/mild,n=67),T2(moderate,n=56),and T3(severe,n=48).Ordered logistic regression was used to analyze the factors influen⁃cing the severity of TA/IF,while the predictive value of FIB for the severity of TA/IF was assessed using the receiver oper⁃ating characteristic(ROC)curve.Results Compared with the normal FIB group,the high FIB group had a significantly higher proportion of moderate-to-severe TA/IF;clinical manifestations were worse in patients within the T2 and T3 groups;age,FIB,and triglycerides(TG)emerged as independent risk factors for the severity of TA/IF in IMN patients,with FIB displaying notable predictive value for moderate-to-severe cases of TA/IF.Conclusion Reasonable control of FIB may reduce the risk of developing moderate-to-severe TA/IF in IMN patients.

关 键 词：纤维蛋白原 特发性膜性肾病 肾小管萎缩/间质纤维化 

分 类 号：R692[医药卫生—泌尿科学]