| 谭云芝,邹毅.尿液高迁移率族蛋白 B1、胰岛素样生长因子结合蛋白 -7在原发性 IgA肾病表达及与病情严重程度和预后的关系[J].安徽医药,2025,29(2):280-284. |
| 尿液高迁移率族蛋白 B1、胰岛素样生长因子结合蛋白 -7在原发性 IgA肾病表达及与病情严重程度和预后的关系 |
| The expression of urinary HMGB1 and IGFBP7 in patients with primary IgA nephropathy and their relationship with disease severity and prognosis |
| |
| DOI：10.3969/j.issn.1009-6469.2025.02.013 |
| 中文关键词: 自身免疫肾病 免疫球蛋白 A 高迁移率族蛋白 B1 胰岛素样生长因子结合蛋白 -7 严重程度 预后 |
| 英文关键词: Autoimmune kidney disease Immunoglobulin A High mobility group protein B1 Insulin like growth factor binding protein-7 Severity Prognosis |
| 基金项目: |
|
| 摘要点击次数: 674 |
| 全文下载次数: 289 |
| 中文摘要: |
| 目的分析原发性免疫球蛋白 A(IgA)肾病病人尿高迁移率族蛋白 B1(HMGB1)、胰岛素样生长因子结合蛋白 -7(IGFBP7)表达及其与病情严重程度和预后的关系。方法选取 2018年 1月至 2020年 12月在恩施土家族苗族自治州中心医院诊治的原发性 IgA肾病病人 104例作为研究对象，根据疾病严重程度分为轻度组( 33例)、中度组( 44例)和重度组( 27例)。对病人进行预后随访，分为预后良好组( 78例)和预后不良组( 26例)。采用 Pearson和 Spearman法分别分析尿 HMGB1、IGFBP7水平以及二者与血肌酐、 24 h尿蛋白定量和病情严重程度、预后不良的相关性；采用 logistic回归分析重度原发性 IgA肾病以及原发性 IgA肾病病人预后不良的影响因素；采用受试者操作特征曲线( ROC曲线)分析尿 HMGB1、IGFBP7对重度原发性 IgA肾病以及原发性 IgA肾病病人预后不良的评估价值。结果轻度、中度和重度组血肌酐、 24 h尿蛋白定量、 C反应蛋白( CRP)、钙素原( PCT)和白细胞计数( WBC)、尿 HMGB1［( 6.72±1.02)μg/L、(9.61±2.17)μg/L、(12.51±3.14)μg/L］、 IGFBP7［( 2.25±0.58)降μg/L、(5.32±1.26)μg/L、(15.72±3.65)μg/L］水平依次显著增加。预后不良组尿 HMGB1［(14.92±4.45)μg/L比( 7.62±1.26)μg/L］、 IGFBP7［(18.73±3.57)μg/L比( 3.15±1.03)μg/L］水平显著高于预后良好组( P<0.05)。根据相关性分析得知，尿 HMGB1、IGFBP7水平呈正相关( P<0.05)二者均与血肌酐、 24 h尿蛋白定量、 CRP、PCT和 WBC、疾病严重程度和预后不良呈正相关( P<0.05)。根据 logistic回归分析得知，H，MGB1、IGFBP7是影响重度原发性 IgA肾病的危险因素(P<0.05)，HMGB1、IGFBP7也是原发性 IgA肾病病人预后不良的危险因素( P<0.05)。根据 ROC曲线得知，尿 HMGB1、IGFBP7二者联合优于各自单独诊断重度原发性 IgA肾病( Z联合比 HMGB1=2.41、Z联合比 IGFBP7=2.32，均 P<0.05)。尿 HMGB1、IGFBP7二者联合优于各自单独预测原发性 IgA肾病病人预后不良( Z联合比 HMGB1=2.33、Z联合比 IGFBP7=2.12，均 P<0.05)。结论原发性 IgA肾病病人尿 HMGB1、IGFBP7表达水平显著升高，二者与病情严重程度和预后密切相关，二者联合可以更好地评估病人病情严重程度和预后。 |
| 英文摘要: |
| Objective To analyze the expression of high mobility group protein B1 (HMGB1) and insulin-like growth factor binding protein-7 (IGFBP7) in urine of patients with primary immunoglobulin A (IgA) nephropathy and their relationship with disease severityand prognosis. Methods A total of 104 patients with primary IgA nephropathy who were diagnosed and treated in Enshi Tujia andMiao Autonomous Prefecture Central Hospital from January 2018 to December 2020 were regarded as the study subjects. They weregrouped into mild group (33 cases), moderate group (44 cases), and severe group (27 cases) based on the severity of the disease. The pa-tients were followed up and divided into the good prognosis group (78 cases) and the poor prognosis group (26 cases). Pearson andSpearman methods were used to analyze urine HMGB1 and IGFBP7 levels and their correlation with serum creatinine and 24-hour urine protein quantification, disease severity and poor prognosis, respectively; logistic regression was applied to analyze the influencingfactors of poor prognosis in patients with severe primary IgA nephropathy and primary IgA nephropathy; receiver operating characteris-tic (ROC) curve was applied to analyze the evaluation value of urine HMGB1 and IGFBP7 in severe primary IgA nephropathy and poorprognosis of patients with primary IgA nephropathy. Results The levels of serum creatinine, 24-hour urine protein, CRP, PCT andWBC, urine HMGB1 [(6.72±1.02)μg/L, (9.61±2.17)μg/L, (12.51±3.14)μg/L] and IGFBP7 [(2.25±0.58)μg/L, (5.32±1.26)μg/L, (15.72±3.65)μg/L] were significantly increased in the mild, moderate and severe groups. The levels of HMGB1 [(14.92±4.45)μg/L vs. (7.62± 1.26)μg/L] and IGFBP7 [(18.73±3.57)μg/L vs. (3.15±1.03)μg/L] in the poor prognosis group were significantly higher than those in the good prognosis group (P<0.05). According to the correlation analysis, the levels of urine HMGB1 and IGFBP7 were positively correlat-ed (P<0.05), and both were positively correlated with serum creatinine, 24-hour urine protein quantification, CRP, PCT and WBC, dis-ease severity and poor prognosis (P<0.05). According to logistic regression analysis, HMGB1 and IGFBP7 were risk factors for severe primary IgA nephropathy (P<0.05), and HMGB1 and IGFBP7 were also risk factors for poor prognosis in patients with primary IgA ne-phropathy (P<0.05). According to the ROC curve, the combination of urine HMGB1 and IGFBP7 was superior to their respective indi-vidual diagnosis of severe primary IgA nephropathy (Zcombination vs. HMGB1=2.41, Zcombination vs. IGFBP7=2.32, P<0.05). The combination of urine HMGB1 and IGFBP7 was superior to each other in predicting poor prognosis in patients with primary IgA nephropathy (Zcombination vs. HMGB1 = 2.33,Zcombination vs. IGFBP7=2.12,P<0.05).Conclusions The expression levels of HMGB1 and IGFBP7 in urine of patients with primary IgAnephropathy are obviously increased, which are closely related to the severity and prognosis of the disease. The combination of the twocan better evaluate the severity of condition and prognosis of the patients. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
