SOX2、SIRT1、sIL-2R在特发性膜性肾病患者血清中的表达及其与临床分期、预后的相关性  

The expression of SOX2,SIRT1,and sIL-2R in the serum of patients with idiopathic membranous nephropathy and their correlation with clinical staging and prognosis

作　　者：孙昊月 金艳华 王欢 张艳宁 付晗 Sun Haoyue;Jin Yanhua;Wang Huan;Zhang Yanning;Fu Han(Department of Nephrology,the General Hospital of Northern Theater Command of the Chinese People's Liberation Army,Liaoning,Shenyang 110000,China)

机构地区：[1]中国人民解放军北部战区总医院肾脏病科,沈阳110000

出　　处：《疑难病杂志》2025年第4期463-467,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：辽宁省科学技术计划项目(2022JH2/101500043)。

摘　　要：目的探究性别决定区Y框蛋白2(SOX2)、沉默信息调节因子1(SIRT1)、可溶性白介素2受体(sIL-2R)在特发性膜性肾病(IMN)患者血清中的表达及其与临床分期、预后的相关性。方法选取2021年1月—2023年1月中国人民解放军北部战区总医院肾脏病科收治的IMN患者316例为IMN组,根据预后情况分为预后不良亚组86例,预后良好亚组230例;另选取同期医院健康体检者316例为健康对照组。采用酶联免疫吸附试验(ELISA)检测血清SOX2、SIRT1、sIL-2R水平;受试者工作特征(ROC)曲线分析血清SOX2、SIRT1、sIL-2R检测对IMN患者预后的预测价值;多因素Logistic回归分析患者预后不良的影响因素。结果与健康对照组比较,IMN组SOX2、sIL-2R水平升高,SIRT1水平降低(t/P=34.115/<0.001、28.962/<0.001、13.579/<0.001);SOX2、sIL-2R水平比较,临床分期三期>二期>一期,SIRT1水平比较,三期<二期<一期(F/P=8.309/<0.001、10.222/<0.001、4.214/0.016);与预后良好亚组比较,预后不良亚组血肌酐、肾小球硬化比例、SOX2、sIL-2R水平显著升高,SIRT1水平显著降低(t/P=12.024/<0.001、12.877/<0.001、8.522/<0.001、7.147/<0.001、6.599/<0.001);血清SOX2、SIRT1、sIL-2R及三者联合预测IMN患者预后的AUC分别为0.753、0.733、0.768、0.863,三者联合优于各自单独预测的AUC(Z/P=3.904/<0.001、2.652/0.008、4.770/<0.001);血肌酐高、肾小球硬化、SOX2高、sIL-2R高是IMN患者预后不良的独立危险因素[OR(95%CI)=2.254(1.346~3.774)、3.474(1.877~6.429)、2.362(1.441~3.871)、1.854(1.371~2.507)],SIRT1高为独立保护因素[OR(95%CI)=0.698(0.567~0.859)]。结论IMN患者血清SOX2、sIL-2R水平显著升高,SIRT1水平显著降低,且三者与临床分期、预后具有密切联系。Objective To investigate the expression of sex determining region Y box protein 2(SOX2),silent information regulator 1(SIRT1),and soluble interleukin-2 receptor(sIL-2R)in the serum of patients with idiopathic membranous nephropathy(IMN),and their correlation with clinical staging and prognosis.Methods A total of 316 IMN patients admitted to the Nephrology Department of the Northern Theater General Hospital of the Chinese people's Liberation Army from January 2021 to January 2023 were selected as IMN group.According to the prognosis,they were divided into poor prognosis subgroup(86 cases)and good prognosis subgroup(230 cases);Another 316 cases of healthy physical examination in the same period were selected as the healthy control group.Enzyme linked immunosorbent assay(ELISA)method was performed to detect serum SOX2,SIRT1,and sIL-2R.Receiver operating characteristic curve(ROC)method was used to analyze the predictive value of serum SOX2,SIRT1,and sIL-2R detection for the prognosis of IMN patients.Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis in patients.Results Compared with the healthy control group,the SOX2 and sIL-2R in the IMN group were conspicuously higher,and SIRT1 was prominently lower(t/P=34.115/<0.001,28.962/<0.001,13.579/<0.001).The levels of SOX2 and sIL-2R in phaseⅢwere higher than those in phaseⅡand higher than those in phaseⅠ,and the levels of SIRT1 in phaseⅢwere lower than those in phaseⅡand lower than those in phaseⅠ(F/P=8.309/<0.001,10.222/<0.001,4.214/0.016).Compared with the good prognosis subgroup,the serum creatinine,proportion of glomerulosclerosis,SOX2,sIL-2R levels in the poor prognosis subgroup were significantly increased,and the SIRT1 level was significantly decreased(t/P=12.024/<0.001,12.877/<0.001,8.522/<0.001,7.147/<0.001,6.599/<0.001).The AUC of serum SOX2,SIRT1,sIL-2R and their combination in predicting the prognosis of IMN patients were 0.753,0.733,0.768 and 0.863,respectively,and the combined AUC of the three was better

关 键 词：特发性膜性肾病 性别决定区Y框蛋白2 沉默信息调节因子1 可溶性白介素2受体 临床分期 预后 

分 类 号：R692.6[医药卫生—泌尿科学]