外周血PLA2R抗体、25(OH)D_(3)、ADAMTS13与原发性膜性肾病患者病情、肾功能损伤的关系  

Relationship between peripheral blood PLA2R antibody,25(OH)D_(3),ADAMTS13 in patients with primary membranous nephropathy and the severity of disease and renal function damage

作　　者：张红霞[1] 田丽会 韩强 ZHANG Hongxia;TIAN Lihui;HAN Qiang(Department of Nephrology,Linfen People′s Hospital,Linfen,Shanxi 041000,China;Department of Clinical Laboratory,Linfen People′s Hospital,Linfen,Shanxi 041000,China)

机构地区：[1]山西省临汾市人民医院肾脏内科,山西临汾041000 [2]山西省临汾市人民医院检验科,山西临汾041000

出　　处：《检验医学与临床》2024年第13期1910-1914,1920,共6页Laboratory Medicine and Clinic

基　　金：山西省临汾市科学技术研究与开发项目[临科技字(2020)10号]。

摘　　要：目的探讨原发性膜性肾病患者外周血M型磷脂酶A2受体(PLA2R)抗体、25羟维生素D_(3)[25(OH)D_(3)]、血管性血友病因子裂解酶13(ADAMTS13)与其病情程度及肾功能损伤的关系。方法选取2021年1月至2023年1月该院收治的122例原发性膜性肾病患者作为研究对象,所有患者均经肾穿刺活检病理检查确诊,根据病理分期结果分为1期组(55例)、2期组(24例)、3期组(43例)。另选同期于本院体检的40例健康者作为健康组。所有患者均随访6个月,并评价患者肾功能情况,患者24 h尿蛋白量减少≥50%、水肿症状减轻或消失,纳入良好组,其余纳入不良组。比较1期组、2期组、3期组、健康组研究指标[PLA2R抗体、25(OH)D_(3)、ADAMTS13活性]、肾功能指标(24 h尿蛋白、ALB)水平。采用Pearson相关分析PLA2R抗体、25(OH)D_(3)水平、ADAMTS13活性与24 h尿蛋白、ALB水平的关系。比较良好组与不良组的PLA2R抗体、25(OH)D_(3)水平、ADAMTS13活性。绘制受试者工作特征(ROC)曲线分析PLA2R抗体、25(OH)D_(3)、ADAMTS13单独及3项指标联合检测对原发性膜性肾病患者肾功能损伤的预测价值。结果PLA2R抗体、24 h尿蛋白水平为3期组>2期组>1期组>健康组,且任意两组间比较,差异均有统计学意义(P<0.05)。25(OH)D_(3)水平、ADAMTS13活性、ALB水平比较,3期组<2期组<1期组<健康组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,PLA2R抗体水平与24 h尿蛋白水平呈正相关(r=0.620,P<0.05);25(OH)D_(3)水平、ADAMTS13活性与24 h尿蛋白水平均呈负相关(r=-0.625、-0.607,P<0.05);PLA2R抗体水平与ALB水平呈负相关(r=-0.591,P<0.05);25(OH)D_(3)水平、ADAMTS13活性与ALB水平均呈正相关(r=0.742、0.899,P<0.05)。良好组患者63例,不良组患者59例。良好组PLA2R抗体水平低于不良组,而25(OH)D_(3)水平、ADAMTS13活性均高于不良组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,PLA2R抗体、25(OH)D_(3)、ADAMTS13�Objective To investigate the relationship between the activity of M-type phospholipase A2 receptor(PLA2R)antibody,25-hydroxyvitamin D_(3)[25(OH)D_(3)],von willebrand factor cleaving enzyme 13(ADAMTS13)in peripheral blood of patients with primary membranous nephropathy and the severity of disease and renal function damage.Methods A total of 122 patients with primary membranous nephropathy admitted to the hospital from January 2021 to January 2023 were selected as research subjects.All patients were diagnosed by renal biopsy pathological examination.According to the pathological staging results,they were divided into stage 1 group(55 cases),stage 2 group(24 cases),and stage 3 group(43 cases).In addition,40 healthy people who underwent physical examination in the hospital during the same period were selected as the healthy group.All patients were followed up for 6 months,and the renal function of patients was evaluated and patients with a reduction of 24 h urinary protein≥50%and edema symptoms were relieved or disappeared were included in the good group,and the rest were included in the poor group.The levels of study indexes[PLA2R antibody,25(OH)D_(3) level,ADAMTS13 activity]and renal function indexes(24 h urinary protein,ALB level)were compared among the stage 1 group,stage 2 group,stage 3 group and healthy group.Pearson correlation analysis was used to analyze the relationship between PLA2R antibody,25(OH)D_(3) level,ADAMTS13 activity and 24 h urinary protein and ALB levels.The levels of PLA2R antibody,25(OH)D_(3) level and ADAMTS13 activity were compared between the good group and the poor group.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of PLA2R antibody,25(OH)D_(3),ADAMTS13 alone and combined detection of the three indicators for renal function in patients with primary membranous nephropathy.Results The levels of PLA2R antibody and 24 h urinary protein in the stage 3 group>stage 2 group>stage 1 group>healthy group,and the differences between two-by-two comparison

关 键 词：M型磷脂酶A2受体 血管性血友病因子裂解酶13 25羟维生素D_(3) 原发性膜性肾病 肾功能 

分 类 号：R692[医药卫生—泌尿科学] R446.1[医药卫生—外科学]