膜性肾病患者血清BAFF、CFB、MCP-1与抗PLA2R抗体的关系及在疗效评估中的作用  

Relationship between serum BAFF,CFB,MCP-1 and anti-PLA2R antibodies in patients with membranous nephropathy and their role in evaluating therapeutic efficacy

作　　者：胡晓燕 李红霞 王银鼎 HU Xiaoyan;LI Hongxia;WANG Yinding(Department of Clinical Laboratory,the Third Affiliated Hospital of Gansu University of Chinese Medicine/Baiyin First;Department of Nephrology,the Third Affiliated Hospital of Gansu University of Chinese Medicine/Baiyin First People's Hospital,Baiyin,Gansu 730900,China)

机构地区：[1]甘肃中医药大学第三附属医院/白银市第一人民医院检验科,甘肃白银730900 [2]甘肃中医药大学第三附属医院/白银市第一人民医院肾内科,甘肃白银730900

出　　处：《检验医学与临床》2025年第8期1106-1111,共6页Laboratory Medicine and Clinic

摘　　要：目的研究血清B细胞活化因子(BAFF)、补体B因子(CFB)、单核细胞趋化蛋白-1(MCP-1)与膜性肾病(MN)抗M型磷脂酶A2受体(PLA2R)抗体的关系及在疗效评估中的作用。方法选取2022年1月至2023年6月该院收治的108例MN患者作为研究对象,根据临床疗效将患者分为缓解组和未缓解组。比较抗PLA2R阳性和阴性、不同病理分期患者血清BAFF、CFB、MCP-1、抗PLA2R抗体水平,比较缓解组和未缓解组的临床资料。采用Pearson相关分析抗PLA2R抗体阳性患者血清BAFF、CFB、MCP-1水平与抗PLA2R抗体水平的相关性。采用Spearman相关分析MN患者血清BAFF、CFB、MCP-1水平与病理分期的相关性。采用多因素Logistic回归分析MN患者治疗后未缓解的影响因素。采用受试者工作特征(ROC)曲线分析血清抗PLA2R抗体、BAFF、CFB、MCP-1对MN患者治疗后未缓解的预测价值。结果抗PLA2R抗体阳性患者有78例,抗PLA2R抗体阴性患者有30例。抗PLA2R抗体阳性患者血清BAFF、CFB、MCP-1、抗PLA2R抗体水平高于阴性患者,差异均有统计学意义(P<0.05)。不同分期MN患者血清BAFF、CFB、MCP-1水平比较结果显示,Ⅰ期<Ⅱ期<Ⅲ期<Ⅳ期,且任意两两间比较,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,抗PLA2R抗体阳性患者血清BAFF、CFB、MCP-1水平与抗PLA2R抗体水平呈正相关(r=0.792、0.823、0.832,P<0.001)。Spearman相关分析结果显示,MN患者血清BAFF、CFB、MCP-1水平与病理分期呈正相关(rs=0.758、0.752、0.717,P<0.001)。33例患者纳入未缓解组,75例患者纳入缓解组,包括完全缓解29例,部分缓解46例。未缓解组病理分期、抗PLA2R抗体、BAFF、CFB及MCP-1水平高于缓解组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,血清BAFF、CFB、MCP-1水平升高是MN患者治疗后未缓解的危险因素(P<0.05)。ROC曲线分析结果显示,血清BAFF、CFB、MCP-1联合预测MN患者治疗后未缓解的曲线下面积为Objective To investigate the relationship between serum B cell activating factor(BAFF),complement B factor(CFB),monocyte chemoattractant protein-1(MCP-1)and anti-M-type phospholipase A2 receptor(PLA2R)antibodies in membranous nephropathy(MN)and their role in the evaluation of disease and efficacy.Methods A total of 108 patients with MN admitted to the hospital from January 2022 to June 2023 were selected as the research object.Patients were divided into remission group and non-remission group according to clinical efficacy.The levels of serum BAFF,CFB,MCP-1,and anti-PLA2R antibodies were compared between patients with positive and negative anti-PLA2R antibodies and different pathological stages.Clinical data of the remission group and the non-remission group were compared.The correlation between the levels of serum BAFF,CFB,and MCP-1 of patients with positive anti-PLA2R antibodies and the level of anti-PLA2R antibodies was analyzed by using pearson correlation analysis.Spearman correlation analysis was used to analyze the correlation between the levels of serum BAFF,CFB,and MCP-1 of MN patients and their pathological stages.Multivariate Logistic regression analysis was used to analyze the factors that affect the non-remission of MN patients after treatment.The predictive value of serum anti-PLA2R antibodies,BAFF,CFB,and MCP-1 for non-remission in MN patients after treatment was analyzed by using receiver operating characteristic(ROC)curve analysis.Results There were 78 patients with positive anti-PLA2R antibodies and 30 patients with negative anti-PLA2R antibodies.The levels of BAFF,CFB,MCP-1,and anti-PLA2R antibodies in the serum of patients with positive anti-PLA2R antibodies were higher than those in patients with negative anti-PLA2R antibodies,and the differences were statistically significant(P<0.05).The results of the comparison of serum BAFF,CFB and MCP-1 levels in MN patients with different stages showed that stageⅠ<stageⅡ<stageⅢ<stageⅣ,and there were statistical significance between any pair comp

关 键 词：B细胞活化因子 补体B因子 单核细胞趋化蛋白-1 膜性肾病 抗M型磷脂酶A2受体 相关性 病情 疗效 

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