| 摘要: |
| 目的探讨尿液可溶性巨噬细胞生物标志物CD163（sCD163）对IgA肾病（IgAN）临床预后的预测价值。方法选取原发性IgAN患者78例，均行肾脏穿刺病理检查，检测尿液sCD163水平。根据病理检查肾小球中新月体的百分比将患者分为C0组（无新月体形成）、C1组（新月体百分比＜25%）、C2组（新月体百分比≥25%），比较3组患者尿液sCD163水平；分析尿液sCD163水平与肾脏穿刺时的平均动脉压（MAP）、尿蛋白肌酐比、血肌酐、估算的肾小球滤过率（eGFR）及肾小球新月体百分比的相关性；以尿液sCD163水平＜1.03为尿液sCD163低水平组，尿液sCD163水平≥1.03为尿液sCD163高水平组，比较两组患者临床预后情况。结果C2组患者尿液sCD163水平高于C0、C1组患者（5.67±7.49vs0.69±0.76、0.57±0.67，均P＜0.05）。尿液sCD163水平与尿蛋白肌酐比、血肌酐、肾小球新月体百分比呈正相关（r=0.787、0.271、0.217，均P＜0.05），与eGFR呈负相关（r=-0.299，P＜0.05）。尿液sCD163高水平组患者的肾脏生存率低于低水平组患者（84.35%vs98.18%，P＜0.05）。结论尿液sCD163可作为预测IgAN临床预后的一项无创性生物标志物。IgAN患者高尿液sCD163提示预后不良。 |
| 关键词: IgA 肾病 新月体 巨噬细胞 sCD163 |
| DOI：10.12056/j.issn.1006-2785.2018.40.14.2018-572 |
| 分类号: |
| 基金项目: |
|
| Value of urinary sCD163 level in prognosis of IgA nephropathy |
|
|
|
the First Affiliated Hospital，Zhejiang University School of Medicine
|
| Abstract: |
| Objective To evaluate the application of urinary soluble macrophage subtypes marker sCD163 level in prognosis of IgA nephropathy. Methods Seventy-eight patients with biopsy-diagnosed primary IgA nephritis (IgAN) were enrolled in the study. The levels of urinary sCD163 were measured. According to the percentage of crescents in glomeruli by pathological examination, patients were divided into groups C0 (0%), C1(＜25%) and C2 (＞25%) and urinary sCD163 levels were compared among three groups. The correlation of urinary sCD163 level with mean arterial pressure (MAP), proteinuria/urine
creatinine, serum creatinine, estimated glomerular filtration rate (eGFR) and the percentage of crescents in glomeruli was analyzed. The use of immune inhibitors, renin-angiotensin system(RAS) inhibitors and clinical prognosis were compared between high sCD163 group (≥1.03) and low sCD163 group (＜1.03). Results Urinary sCD163 in group C2 were significantly elevated compared to group C1 and group C0 (5.67 ±7.49 vs. 0.69 ±0.76 and 0.57 ±0.67, P ＜0.05). Urinary sCD163 was positively correlated with serum creatinine and proteinuria and percentage of crescents in glomeruli (r=0.787, 0.271, 0.217, P＜0.05), and negatively correlated with eGFR (r=-0.299, P＜0.05). The survival of patients in high urinary sCD163 group was lower than that in low sCD163 group (84.35% vs 98.18%, P ＜0.05). Conclusion Urinary sCD163 may serve as a non-invasive biomarker for predicting the clinical outcomes in patients with IgA nephropathy. |
| Key words: IgA nephropathy Crescent Macrophages sCD163 |
