血清APRIL、PLA2R-Ab及25-(OH)D3水平与原发性膜性肾病病情和预后的关系  

Study on the correlation between serum APRIL,PLA2R-Ab,and 25-(OH)D3 levels and the severity and prognosis of primary membranous nephropathy

作　　者：郭音 任海青 郭晓阳 左江华[1] 王婷 GUO Yin;REN Haiqing;GUO Xiaoyang;ZUO Jianghua;WANG Ting(Department of Laboratory,Xingtai People's Hospital,Xingtai 054000,Hebei,China;不详)

机构地区：[1]邢台市人民医院检验科,河北邢台054000 [2]邢台市人民医院肾脏内科,河北邢台054000

出　　处：《实用医学杂志》2025年第8期1199-1204,共6页The Journal of Practical Medicine

基　　金：河北省卫生健康委科研基金项目(编号:20211222);邢台市重点研发计划自筹项目(编号:2023ZC053)。

摘　　要：目的探讨增殖诱导配体(APRIL)、M型磷脂酶A2受体抗体(PLA2R-Ab)、25-羟维生素D3[25-(OH)D3]水平变化与原发性膜性肾病(PMN)病情程度及预后的关系。方法采用前瞻性研究模式,选取邢台市人民医院确诊的PMN患者100例作为PMN组,健康体检志愿者100例作为对照组,对比两组研究对象的血清APRIL、PLA2R-Ab及25-(OH)D3水平,并按照PNM疾病分期、治疗结局进行分层对比,采用简单线性相关法分析血清APRIL、PLA2R-Ab及25-(OH)D3与肾功能指标的相关性,采用多元回归模型分析上述指标与患者治疗效果预后的关系。结果PMN组的血清APRIL、PLA2R-Ab水平高于对照组,25-(OH)D3水平低于对照组,两组之间差异具有统计学意义(P<0.05);100例PMN患者,Ⅰ期20例、Ⅱ期42例、Ⅲ期34例、Ⅳ期4例,Ⅲ+Ⅳ期患者的血清APRIL、PLA2R-Ab水平高于Ⅰ+Ⅱ期患者,25-(OH)D3水平低于Ⅰ+Ⅱ期患者,两组之间差异具有统计学意义(P<0.05);PMN患者的血清APRIL、PLA2R-Ab水平与尿素氮(BUN)、肌酐(Scr)、24小时尿蛋白呈显著正相关关系(P<0.05),APRIL、PLA2R-Ab与TP(总蛋白)、白蛋白(ALB)呈负相关关系(P<0.05),PMN患者的血清25-(OH)D3水平与BUN、Scr、24小时尿蛋白呈负相关关系(P<0.05)。经过治疗,有42例患者完全缓解,有58例患者未达到缓解标准,缓解组患者在治疗前、治疗12个月后的血清APRIL、PLA2R-Ab水平均明显低于未缓解组,缓解组患者在治疗前、治疗12个月后的血清25-(OH)D3水平高于未缓解组患者(P<0.05)。结论血清APRIL、PLA2R-Ab水平增高导致的免疫功能异常与PMN发病及病情严重程度有关,肾功能损伤导致血清25-(OH)D3水平明显降低,并且上述三项指标反映出PMN疾病发生、病情程度及预后情况。Objective Investigating the correlation between fluctuations in proliferation-inducing ligand(APRIL),M-type phospholipase A2 receptor antibody(PLA2R Ab),and 25-hydroxyvitamin D3[25-(OH)D3]levels and their impact on the severity and prognosis of primary membranous nephropathy(PMN).Methods A prospective study design was employed,wherein 100 confirmed PMN patients from Xingtai People's Hospital were recruited as the PMN group,and 100 healthy volunteers served as the control group.The levels of APRIL,PLA2R Ab,and 25-(OH)D3 were compared between the two groups of participants,stratified by PMN disease stage and treatment outcomes.A simple linear correlation analysis was conducted to evaluate the correlation between APRIL,PLA2R Ab,and 25-(OH)D3 with renal function indicators.Additionally,a multiple regression model was utilized to analyze the associations between these indicators and patient treatment outcomes as well as prognosis.Results The levels of APRIL and PLA2R Ab in the MN group were significantly higher than those in the control group,whereas the levels of 25-(OH)D3 were significantly lower than those in the control group(P<0.05).Among 100 patients with PMN,there were 20 in stage I,42 in stageⅡ,34 in stageⅢ,and 4 in stageⅣ.The levels of APRIL and PLA2R Ab in stageⅢ+Ⅳpatients were significantly higher than those in stageⅠ+Ⅱpatients,while the level of 25-(OH)D3 was significantly lower in stageⅢ+Ⅳpatients compared to stageⅠ+Ⅱpatients(P<0.05).In PMN patients,serum APRIL and PLA2R-Ab levels were negatively correlated with urea nitrogen(BUN),creatinine(Scr),and 24-h urinary protein(P<0.05).Additionally,APRIL and PLA2R-Ab levels were positively correlated with total protein(TP)and albumin(ALB)(P<0.05),while serum 25-(OH)D3 levels were negatively correlated with BUN,Scr,and 24-h urinary protein(P<0.05).After treatment,42 patients achieved complete remission,while 58 patients did not meet the remission criteria.Serum APRIL and PLA2R-Ab levels in the remis-sion group were significantly lower than t

关 键 词：增殖诱导配体 M型磷脂酶A2受体抗体 25-羟维生素D3 原发性膜性肾病 预后 

分 类 号：R692[医药卫生—泌尿科学]