肾脏免疫球蛋白沉积与糖尿病肾脏病的临床相关性研究  

Study on the clinical associations between different types of renal immunoglobulin deposition and diabetic kidney disease

作　　者：赵妍[1] 郭佳欣 程健[3] 祁伟[4] 赵晶晶 Zhao Yan;Guo Jiaxin;Cheng Jian;Qi Wei;Zhao Jingjing(Department of Endocrinology,The Second Hospital of Tianjin Medical University,Tianjin 300211,China;Department of Endocrinology,Tianjin Chest Hospital,Tianjin 300222,China;Tianjin Institute of Industrial Biotechnology,Chinese Academy of Sciences,Tianjin 300308,China;Department of Infectious Diseases,The Second Hospital of Tianjin Medical University,Tianjin 300211,China;Department of Nephrology,The Second Hospital of Tianjin Medical University,Tianjin 300211,China)

机构地区：[1]天津医科大学第二医院内分泌科,天津300211 [2]天津市胸科医院内分泌科,天津300222 [3]中国科学院天津工业生物技术研究所,天津300308 [4]天津医科大学第二医院感染性疾病科,天津300211 [5]天津医科大学第二医院肾内科,天津300211

出　　处：《国际内分泌代谢杂志》2024年第3期161-166,共6页International Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金(82202578);天津市科技计划项目(23YDTPJC00990);天津市卫生健康委员会中医中西医结合科研课题(2021077);天津市教委科研计划项目(2023ZD003);天津医科大学第二医院临床医学研究项目(2020LC14)。

摘　　要：目的探讨肾脏免疫球蛋白沉积与糖尿病肾脏病(diabetic kidney disease,DKD)的临床相关性。方法将肾活检确诊为DKD的患者分为4组:(1)一阳(IgA+IgM-IgG-/IgA-IgM+IgG-/IgAIgM-IgG+)。(2)二阳(IgA+IgM+IgG-/IgA+IgM-IgG+/IgA-IgM+IgG+)。(3)全阳(IgA+IgM+IgG+)。(4)全阴(IgA-IgM-IgG-)。收集患者的临床资料,分析肾脏免疫球蛋白沉积与DKD的临床相关性,通过DKD的肾脏终点事件评估其对肾脏预后的预测价值。结果全阳组患者的尿蛋白定量明显高于其他3组;单因素COX回归分析示全阳组发生肾脏终点事件的风险更高,多因素COX回归分析示免疫球蛋白沉积对肾脏预后无统计学意义。结论肾脏多种免疫球蛋白沉积增加了DKD尿蛋白的漏出,但与肾脏预后无明显相关性。Objective To explore the clinical associations between different types of renal immunoglobulin deposition and diabetic kidney disease(DKD).Methods The patients diagnosed as DKD who underwent renal puncture biopsy were divided into four groups,which were as follows:(1)One-positive(IgA+IgM-IgG-/IgA-IgM+IgG-/IgA-IgM-IgG+);(2)Two-positive(IgA+IgM+IgG-/IgA+IgM-IgG+/IgAIgM+IgG+);(3)All-positive(IgA+IgM+IgG+);(4)All-negative(IgA-IgM-IgG-).Clinical data of patients were collected to analyze the clinical correlation between renal immunoglobulin deposition and DKD,and the value of renal endpoint events was assessed to predict renal prognosis in DKD patients.Results The urinary protein quantity of the all-positive group was higher than that of the other three groups.Univariate COX regression analysis showed that the risk of renal endpoint events was higher in all-positive groups,while multi-factor COX regression analysis showed that immunoglobulin deposition had no statistical significance to renal outcome.Conclusion Multiple immunoglobulin deposition in the kidney increased urinary protein leakage in DKD patients,but there was no significant correlation with renal prognosis.

关 键 词：糖尿病肾脏病 肾脏沉积 免疫球蛋白 肾脏终点事件 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]