摘要
目的探讨血清分泌型磷脂酶A2-IB(sPLA2-IB)、生长分化因子-15(GDF-15)、可溶性生长刺激表达因子2(sST2)在特发性膜性肾病(IMN)患者中表达及临床意义。方法选取2016年1月至2019年6月在我科接受治疗的125例IMN患者作为IMN组,继发性膜性肾病患者60例作为SMN组。另选取我院体检健康志愿者100例作为对照组。采用酶联免疫吸附法检测两组血清sPLA2-IB、GDF-15、sST2水平。IMN患者随访1年根据终末期肾病(GFR<15 mL/(min·1.73 m^(2))发生情况,分为预后良好组(n=101)和预后不良组(n=24)。绘制ROC曲线分析联合检测血清sPLA2-IB、GDF-15、sST2预测IMN患者预后的临床价值。结果IMN组血清sPLA2-IB、GDF-15、sST2水平高于SMN组、对照组,SMN组血清sPLA2-IB、GDF-15、sST2水平高于对照组,差异有统计学意义(P<0.05)。IMN患者治疗后的血清sPLA2-IB、GDF-15、sST2水平低于治疗前,差异有统计学意义(P<0.05)。随着病理分期的升高IMN患者的血清sPLA2-IB、GDF-15、sST2水平逐渐升高(P<0.05)。预后不良组血清sPLA2-IB、GDF-15、sST2水平高于预后良好组,差异有统计学意义(P<0.05)。Spearman相关性分析示,血清sPLA2-IB、GDF-15、sST2水平与血清Cr、24h uP呈正相关,与GFR呈负相关(P<0.05)。ROC曲线分析,治疗前联合检测血清sPLA2-IB、GDF-15、sST2预测IMN患者预后状况的曲线下面积为0.901(95%CI:0.828~0.965,P<0.001),灵敏度和特异性分别为90.8%、75.9%。结论IMN患者血清sPLA2-IB、GDF-15、sST2表达水平明显升高,且与患者病情变化及临床预后密切相关,并对患者的辅助诊断、病情及预后评估有重要的参考价值。
Objective To investigate serum secreted phospholipase A2-IB(sPLA2-IB),growth differentiation factor-15(GDF-15),and sST2 in patients with idiopathic membranous nephropathy(IMN)by studying expressions and clinical significances.Methods 125 IMN patients who received treatment in our department from January,2016 to June,2019 were selected as the IMN group,while 60 patients with secondary membranous nephropathy were selected as the SMN group.In addition,100 healthy volunteers in our hospital were selected as the control group.Enzyme-linked immunosorbent assay was conducted to detect serum levels of sPLA2-IB,GDF-15 and sST2 in both groups.IMN patients were followed up for 1 year according to the occurrence of end-stage renal disease(GFR<15 mL/(min·1.73 m^(2)),and they were divided into the good prognosis group(n=101)and the poor prognosis group(n=24).We drew ROC curve to analyze the clinical value of combined detection of serum sPLA2-IB,GDF-15,sST2 in predicting the prognosis of IMN patients.Results Serum levels of sPLA2-IB,GDF-15 and sST2 in the IMN group were higher than those in the SMN group and the control group.The levels of serum sPLA2-IB,GDF-15 and sST2 in the SMN group were higher than those in the control group,and the difference was statistically significant(P<0.05).Serum sPLA2-IB,GDF-15 and sST2 levels of IMN patients after treatment were lower than before treatment,and the difference was statistically significant(P<0.05).With the increase of pathological stage,serum sPLA2-IB,GDF-15 and sST2 levels of IMN patients gradually increased(P<0.05).The levels of serum sPLA2-IB,GDF-15 and sST2 in the poor prognosis group were higher than those in the good prognosis group,and the difference was statistically significant(P<0.05).Spearman correlation analysis showed that serum sPLA2-IB,GDF-15,and sST2 levels were positively correlated with serum Cr and 24h uP,while negatively correlated with GFR(P<0.05).ROC curve analysis showed as following:the area under the curve of combined detection of serum sPLA2-IB,GDF-15,and sST2 before treatment to predict the prognosis of IMN patients was 0.901(95%CI:0.828-0.965,P<0.001),and the sensitivity and specificity were 90.8%and 75.9%,respectively.Conclusion The expression levels of serum sPLA2-IB,GDF-15 and sST2 in patients with IMN are significantly increased,and are closely related to the changes in the patient’s condition and clinical prognosis.And it has an important reference value for the auxiliary diagnosis,condition and prognosis assessment of patients.
作者
张雨
高爽
张媛
ZHANG Yu;GAO Shuang;ZHANG Yuan(Department of Nephrology, The Second Hospital of Qinhuangdao, Qinhuangdao 066600, China)
出处
《标记免疫分析与临床》
CAS
2022年第1期96-100,共5页
Labeled Immunoassays and Clinical Medicine
基金
秦皇岛市科技支撑计划项目(编号:201802A105)。
