MHR对IgAN肾小球硬化严重程度的预测价值  

Predictive value of MHR for the severity of IgAN glomerulosclerosis

作　　者：陈仁芬 陈龙庚 郭耿耿 陈晴 谢祖刚 CHEN Renfen;CHEN Longgeng;GUO Genggeng;CHEN Qing;XIE Zugang(Department of Nephrology,Longyan People’s Hospital,Longyan 364000,China)

机构地区：[1]龙岩人民医院肾内科,福建龙岩364000 [2]龙岩人民医院肾病学科,福建龙岩364000

出　　处：《广州医药》2024年第12期1482-1489,共8页Guangzhou Medical Journal

基　　金：龙岩市科技计划项目(2022LYF17009)。

摘　　要：目的研究单核细胞/高密度脂蛋白比值(MHR)对免疫球蛋白A肾病(IgAN)患者肾小球硬化严重程度的预测价值。方法回顾性分析2016年1月—2022年6月龙岩人民医院收治的296例IgAN患者的临床和肾脏病理资料,参照牛津分型将患者分为无肾小球节段性硬化组(S0组)、有肾小球节段性硬化组(S1组)及球性硬化组;根据Katafuch肾小球积分将患者分为低三分位组、中三分位组及高三分位组。比较不同肾小球硬化程度和不同Katafuchi肾小球积分患者的MHR水平,对MHR与Katafuchi肾小球积分的关系进行相关性分析,绘制受试者操作特征(ROC)曲线分析MHR对肾小球硬化程度的预测效能。结果S1组和球性硬化组的单核细胞计数分别为(0.41±0.11)×10~9/L、(0.45±0.10)×10~9/L,均高于S0组的(0.30±0.06)×10~9/L,对比差异有统计学意义(t1=10.381,P1<0.001;t2=12.169,P2<0.001),球性硬化组的HDL水平为(1.14±0.16)mmoL/L,低于S0组(1.26±0.24)mmoL/L(t2=2.992,P2=0.003)。S1组和球性硬化组的MHR为(0.36±0.04)、(0.44±0.05),大于S0组的(0.24±0.02),对比差异有统计学意义(t1=37.852,P1<0.001;t2=42.037,P2<0.001),球性硬化组的MHR大于S1组(t3=9.673,P3<0.001)。中三分位组和高三分位组的单核细胞计数为(0.34±0.06)×10~9/L、(0.48±0.10)×10~9/L,高于低三分位组的(0.27±0.05)×10~9/L,对比差异有统计学意义(t1=9.017,P1<0.001;t2=20.080,P2<0.001),高三分位组的单核细胞计数高于中三分位组(t3=8.855,P3<0.001)。高三分位组的HDL水平为(0.96±0.12)mmoL/L,低于低三分位组的(1.23±0.21)mmoL/L和中三分位组的(1.19±0.16)mmoL/L,对比差异有统计学意义(t2=8.132,P2<0.001;t3=7.954,P3<0.001)。高三分位组的MHR为(0.49±0.07),大于低三分位组的(0.25±0.03)和中三分位组(0.26±0.08),对比差异有统计学意义(t2=35.382,P2<0.001;t3=15.146,P3<0.001)。相关性分析显示,单核细胞与Katafuchi肾小球积分呈正相关(r=0.58,P<0.05),HDL与Katafuchi肾小球积分呈负相关(r=Objective To explore predictive value of the monocyte/high-density lipoprotein ratio(MHR)on the severity of glomerulosclerosis in patients with immunoglobulin A nephropathy(IgAN).Methods The clinical and renal pathological data of 296 IgAN patients admitted to Longyan People's Hospital from January 2016 to June 2022 were analyzed retrospectively,and the patients were divided into no segmental sclerosis group(S0),segment sclerosis group(S1)and glomerular sclerosis group according to Oxford classification;the patients were divided into low group,middle group and high group according to Katafuchi score.MHR levels in patients with different degrees of glomerular sclerosis and different Katafuchi score were compared,the relationship between MHR and Katafuchi glomerular integration was analyzed,and ROC curves were drawn to analyze the predictive efficacy of MHR on the degree of glomerular sclerosis.Results Monocyte counts in the S1 and glomerular sclerosis groups[(0.41±0.11)109/L,(0.45±0.10)109/L]were all significantly higher than the S0 group(0.30±0.06)109/L,with statistically significant difference(t1=10.381,P1<0.001,t2=12.169,P2<0.001).The HDL level(1.14±0.16)mmoL/L was significantly lower than that in the S0 group(1.26±0.24)mmoL/L(t2=2.992,P2=0.003).The MHR in S1 and glomerular sclerosis group[(0.36±0.04),(0.44±0.05)]were significantly greater than S0(0.24±0.02)(t1=37.852,P1<0.001,t2=42.037,P2<0.001),and the MHR in glomerular sclerosis group was significantly greater than that of S1(t3=9.673,P3<0.001).The monocyte counts of middle and high group[(0.34±0.06)109/L,(0.48±0.10)109/L]were significantly higher than the low group(0.27±0.05)109/L(t1=9.017,P1<0.001;t2=20.080,P2<0.001)and high group was significantly higher than middle group(t3=8.855,P3<0.001).The HDL level of high group(0.96±0.12)mmoL/L was significantly lower than the low group(1.23±0.21)mmoL/L and middle group(1.19±0.16)mmoL/L,with statistically significance(t2=8.132,P2<0.001,t3=7.954,P3<0.001).The MHR(0.49±0.07)in the high group was signif

关 键 词：单核细胞/高密度脂蛋白胆固醇比值 免疫球蛋白A肾病 肾小球硬化 预测价值 

分 类 号：R692.6[医药卫生—泌尿科学]