摘要
目的探讨血清异常糖基化IgA1(Gd-IgA1)与IgA肾病(IgAN)患者临床病理特点及激素治疗后反应的关系。方法前瞻性收集2018年1月~2018年12月本科室住院的慢性肾炎及肾病综合征患者,以肾活检证实为IgAN并同意使用激素治疗的患者40例作为实验组,以肾活检证实为膜性肾病的患者20例作为疾病对照组,以本院体检中心健康体检者20例作为空白对照组。采集以上各组生化指标,收集各组血清及IgAN患者激素治疗1个月后的血清,利用KM55 ELISA试剂盒检测上述血清样本中Gd-IgA1水平,并分析其与24 h尿蛋白定量的相关性,将上述IgAN患者的肾活检病理切片进行Haas分级,对分级的结果进行统计学分析。结果与健康对照组(3.56±0.30)mg/L及疾病对照组(3.40±0.41)mg/L比较,IgAN患者血清Gd-IgA1水平(9.44±0.74)mg/L升高,差异具有统计学意义(P均<0.001);IgAN患者血清Gd-IgA1水平与患者的24 h尿蛋白定量、肾脏损伤程度呈正相关(P<0.05),并且经激素治疗1个月后,IgAN患者Gd-IgA1水平较使用激素前下降(P<0.05)。结论血清Gd-IgA1水平与IgAN患者病情程度呈正相关,且经激素治疗后水平下降,提示检测血清Gd-IgA1水平对诊断IgAN及判断预后有一定意义。
Objective To observe the relationship between serum Gd-IgA1 level and clinicopathological features as well as hormone response in patients with IgA nephropathy.Methods The perspectively review identified 40 patients with IgAN were confirmed by renal biopsies as experimental group,and these patients have been treated with hormones therapy in our department.And 20 patients with membranous kidney disease and 20 normal healthy controls in physical examination center of our hospital were regarded as control groups.The level of Gd-IgA1 in all serum samples and the general data of patients,renal function,24 h urinary protein quantity and IgA level were statistically analyzed.The pathological sections of IgA nephropathy were graded by Haas,and the results of grading were statistically analyzed.Results Compared with normal group(3.56±0.30)mg/L and disease control group(3.40±0.41)mg/L,the level of serum Gd-IgA1 in patients with IgA nephropathy(9.44±0.74)mg/L was higher,and was positively correlated with 24 h urinary protein quantity and renal pathological grade,and the difference was statistically significant(P<0.05).After 1 month of hormonal therapy,the level of Gd-IgA1 in IgAN patients was lower than before(P<0.05).Conclusion The level of serum Gd-IgA1 was positively correlated with the severity of IgA nephropathy,and decreased after hormone treatment,suggesting that serum-Gd-IgA1 could serve as a predictor of renal outcomes in IgAN.Thus,Gd-IgA1 could be significant biomarker for patients with IgAN.
作者
肖勇
贺海东
胡屏
孙蔚倩
徐旭东
唐余燕
XIAO Yong;HE Hai-dong;HU Ping(Department of Emergency,Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University of Medicine,Shanghai 201900)
出处
《临床输血与检验》
CAS
2021年第4期492-496,共5页
Journal of Clinical Transfusion and Laboratory Medicine
基金
国家自然科学基金(No.81774060)
上海市卫计委科研基金课题(No.20184Y0040)
上海市闵行区自然科学研究课题(No.2018MHZ069)资助。
关键词
IGA肾病
Gd-IgA1
激素治疗
生物标记
IgA nephropathy
Galactose-deficient IgA1(Gd-IgA1)
Corticosteroid therapy
Biomarker
