特发性膜性肾病患者血清补体C3水平与血压及估算肾小球滤过率的相关性分析  

Association analysis of serum complement C3 level with blood pressure and estimated glomerular filtration rate in patients with idiopathic membranous nephropathy

作　　者：蒋道芳 马晓燕[1] 王奕[1] 杨欣宇 王一舒 马姝琛[1] 王俊[1] 余超 方路[1] 刘娜[1] Jiang Daofang;Ma Xiaoyan;Wang Yi;Yang Xinyu;Wang Yishu;Ma Shuchen;Wang Jun;Yu Chao;Fang Lu;Liu Na(Department of Nephrology,East Hospital Affiliated to Tongji University,Shanghai 200120,China)

机构地区：[1]同济大学附属东方医院肾内科,上海200120

出　　处：《中华肾脏病杂志》2024年第6期475-480,共6页Chinese Journal of Nephrology

基　　金：国家自然科学基金(82070791、82100708);上海市浦东新区卫生系统联合攻关项目(PW2021D-04);上海市卫健委和上海市中医药管理局项目(ZHYY-ZXYJHZX-202114);上海市浦东新区卫生系统领先人才培养计划(PWR12021-02);上海市浦东新区重点学科项目(PWZxk2022-05);上海市浦东新区卫生系统优秀青年医学人才培养计划(PWRq2023-18)。

摘　　要：该研究为单中心横断面研究,探讨特发性膜性肾病(idiopathic membranous nephropathy,IMN)血清补体C3水平与血压及估算肾小球滤过率(estimated glomerular filtration rate,eGFR)的相关性。回顾性分析2018年8月1日至2023年10月31日在同济大学附属东方医院肾内科经肾活检确诊为IMN的98例患者的临床和病理资料,比较非高血压组(n=37)和高血压组(n=61)人口学特征、血清补体C3及其他临床指标的差异。采用Pearson或Spearman相关分析法分析IMN患者及高血压组IMN患者血清C3水平与eGFR的相关性。采用多因素线性回归分析高血压组IMN慢性肾脏病1~3期患者eGFR的相关因素。结果显示,高血压组患者年龄、血肌酐、胱抑素C、尿微量白蛋白/肌酐、血清C3、C4水平均高于非高血压组,eGFR低于非高血压组(均P<0.05)。相关分析结果显示,IMN患者中血清C3水平与eGFR无相关性(r=0.118,P=0.247),高血压组IMN患者中血清C3水平与eGFR呈正相关(r=0.325,P=0.011)。多因素线性回归分析结果显示,eGFR与年龄(β=-0.328,P=0.013)呈负相关,与血清C3(β=0.228,P=0.048)呈正相关。该研究显示,IMN伴高血压患者血清C3水平高于IMN非高血压患者,且其C3水平与eGFR呈正相关。It was a single-center cross-sectional study to investigate the association of serum C3 level with blood pressure and estimated glomerular filtration rate(eGFR)in patients with idiopathic membranous nephropathy(IMN).The clinical and pathological data of 98 patients with IMN diagnosed by renal biopsy in the Department of Nephrology of East Hospital Affiliated to Tongji University from August 1,2018 to October 31,2023 were retrospectively analyzed.The demographic characteristics,serum complement C3 and other clinical data were compared between the non-hypertension group(n=37)and hypertension group(n=61).Pearson or Spearman correlation analysis method was used to analyze the correlation between serum C3 and eGFR in IMN patients and IMN patients with hypertension.Multiple linear regression analysis was used to analyze the related factors of eGFR in IMN patients with chronic kidney disease stage 1-3 in hypertension group.The results showed that compared with the non-hypertension group,the patients in hypertension group were older,and had higher levels of serum creatinine,cystatin C,urinary microalbumin to creatinine ratio,serum C3 and C4,and lower eGFR(all P<0.05).The correlation analysis showed that there was no correlation between serum C3 level and eGFR in IMN patients(r=0.118,P=0.247).However,serum C3 level was positively correlated with eGFR in IMN patients with hypertension(r=0.325,P=0.011).Multiple linear regression analysis showed that eGFR was negatively correlated with age(β=-0.328,P=0.013),and positively correlated with serum C3 level(β=0.228,P=0.048).The study shows that serum C3 level in hypertension group is higher than that in non-hypertension group in IMN patients.Moreover,serum C3 is positively correlated with eGFR.

关 键 词：肾小球肾炎 膜性 高血压 补体C3 估算肾小球滤过率 

分 类 号：R692[医药卫生—泌尿科学]