血清总胆红素、25-(OH)D3对原发性膜性肾病患者治疗效果的评估价值  

Evaluation Value of Serum Total Bilirubin and 25-(OH)D3 in Assessing Treatment Efficacy in Primary Membranous Nephropathy Patients

作　　者：张钧皓 王晨丹[1] ZHANG Junhao;WANG Chendan(Department of Nephrology,Shanxi Provincial People's Hospital,Taiyuan,Shanxi 030000,China)

机构地区：[1]山西省人民医院肾内科,山西太原030000

出　　处：《转化医学杂志》2024年第11期1866-1870,共5页Translational Medicine Journal

基　　金：山西省科技厅自然科学研究面上项目(202103021224382)。

摘　　要：目的探讨血清总胆红素(TBIL)、25羟基维生素D3[25-(OH)D3]对原发性膜性肾病(PMN)患者治疗效果的评估价值。方法选取2021年1月至2023年6月山西省人民医院肾内科收治的PMN患者155例(PMN组)和近期来院健康体检志愿者80名(对照组),根据1年后治疗效果将PMN患者分为未缓解组(60例)和缓解组(95例)。采用比色法检测血清TBIL水平,酶联免疫吸附法检测25-(OH)D3水平。以PMN患者治疗效果为因变量,多因素非条件Logistic回归确定其影响因素,绘制受试者工作特征曲线分析血清TBIL、25-(OH)D3水平对其的评估价值。结果PMN组血清TBIL、25-(OH)D3水平低于对照组(P<0.05)。155例PMN患者治疗未缓解率为38.71%(60/155)。PMN患者治疗未缓解的独立危险保护因素为白蛋白高、估计肾小球滤过率高、TBIL高、25-(OH)D3高,独立危险因素为24h尿蛋白高(P<0.05)。血清TBIL、25-(OH)D3水平联合评估PMN患者治疗未缓解的曲线下面积为0.891,大于血清TBIL、25-(OH)D3水平单独评估的0.780、0.787(P<0.05)。结论PMN患者血清TBIL、25-(OH)D3水平降低与治疗未缓解密切相关,可能成为PMN患者治疗效果的辅助评估指标。Objective To explore the evaluation value of serum total bilirubin(TBIL)and 25-hydroxyvitamin D3[25-(OH)D3]in assessing the treatment efficacy in patients with primary membranous nephropathy(PMN).Methods A total of 155 PMN patients(PMN group)treated in the Department of Nephrology,Shanxi Provincial People's Hospital from January 2021 to June 2023,and 80 healthy volunteers who underwent physical check-ups(control group)were selected.Based on the treatment outcomes one year later,the PMN patients were divided into the non-remission group(60 cases)and the remission group(95 cases).Serum TBIL levels were detected using colorimetry,and 25-(OH)D3 levels were detected using enzyme-linked immunosorbent assay.Multivariate unconditional logistic regression was used to determine the influencing factors of treatment outcomes,and receiver operating characteristic curves were drawn to analyze the evaluation value of serum TBIL and 25-(OH)D3 levels.Results The serum TBIL and 25-(OH)D3 levels in the PMN group were lower than those in the control group(P<0.05).The non-remission rate of treatment in 155 PMN patients was 38.71%(60/155).Independent protective factors for non-remission in PMN patients included high albumin,high estimated glomerular filtration rate,high TBIL,and high 25-(OH)D3,while the independent risk factor was high 24-hour urine protein(P<0.05).The area under the curve for the combined assessment of serum TBIL and 25-(OH)D3 levels for non-remission of treatment in PMN patients was 0.891,higher than that for serum TBIL and 25-(OH)D3 levels alone(0.780 and 0.787,respectively)(P<0.05).Conclusion Decreased serum TBIL and 25-(OH)D3 levels are closely associated with treatment non-remission in PMN patients and may serve as auxiliary indicators for evaluating treatment outcomes.

关 键 词：原发性膜性肾病 总胆红素 25羟基维生素D3 治疗效果 评估价值 

分 类 号：R692.6[医药卫生—泌尿科学]