目的探讨血清半乳糖缺陷型IgA1(galactose-deficient IgA1,Gd-IgA1)、补体C4、补体因子H(complement factor H,CFH)和补体因子H相关蛋白(complement factor H related proteins,CFHRP)1、3、5在IgA肾病(IgA nephropathy,IgAN)中的诊断...目的探讨血清半乳糖缺陷型IgA1(galactose-deficient IgA1,Gd-IgA1)、补体C4、补体因子H(complement factor H,CFH)和补体因子H相关蛋白(complement factor H related proteins,CFHRP)1、3、5在IgA肾病(IgA nephropathy,IgAN)中的诊断价值。方法本研究为回顾性研究,收集2021年11月1日至2023年12月31日在雅安市人民医院行肾穿刺活检诊断为原发性IgAN的患者58例,同期其他肾小球疾病患者48例和健康志愿者20名作为对照,采用酶联免疫吸附分析法检测上述对象血清IgA、补体C4、Gd-IgA1、CFH、CFHRP1、3、5浓度并行组间比较,绘制受试者工作特征曲线评估血清Gd-IgA1、Gd-IgA1/CFH、CFHRP1/CFH、CFHRP5/CFH在IgAN中的诊断价值,筛选出受试者工作特征曲线的曲线下面积较大的指标Gd-IgA1、CFHRP1/CFH、CFHRP5/CFH,重点研究Gd-IgA1分别联合检测CFHRP1/CFH、CFHRP5/CFH对IgAN的诊断价值。结果原发性IgAN组患者血清IgA[1.568(1.344,1.705)g/L比1.177(0.618,1.893)g/L、0.538(0.433,0.732)g/L]、补体C4[0.547(0.494,0.643)g/L比0.396(0.312,0.515)g/L、0.289(0.186,0.356)g/L]、Gd-IgA1[0.003(0.002,0.004)g/L比0.002(0.001,0.003)g/L、0.0017(0.0010,0.0020)g/L]、CFHRP1[0.013(0.011,0.015)g/L比0.010(0.009,0.013)g/L、0.011(0.009,0.012)g/L]水平及Gd-IgA1/CFH[0.023(0.017,0.030)比0.012(0.009,0.021)mmol/L、0.005(0.004,0.007)mmol/L]、CFHRP1/CFH[0.115(0.091,0.161)比0.093(0.061,0.108)、0.038(0.028,0.043)]比值明显高于其他肾小球疾病组和健康组(P<0.05),血清CFH[0.000109(0.000089,0.000110)g/L比0.000285(0.000259,0.000347)g/L]浓度低于健康组(P<0.05);血清Gd-IgA1联合CFHRP1/CFH、CFHRP5/CFH诊断原发性IgAN的曲线下面积分别为0.946(95%CI:0.908~0.985)、0.926(95%CI:0.874~0.978),灵敏度分别为80%、90%,特异度分别为93.9%、86.3%。结论Gd-IgA1联合检测CFHRP1/CFH、CFHRP5/CFH对于诊断原发性IgAN具有较好价值,或可作为诊断IgAN的潜在无创性生物标志物。展开更多
文摘目的探讨血清半乳糖缺陷型IgA1(galactose-deficient IgA1,Gd-IgA1)、补体C4、补体因子H(complement factor H,CFH)和补体因子H相关蛋白(complement factor H related proteins,CFHRP)1、3、5在IgA肾病(IgA nephropathy,IgAN)中的诊断价值。方法本研究为回顾性研究,收集2021年11月1日至2023年12月31日在雅安市人民医院行肾穿刺活检诊断为原发性IgAN的患者58例,同期其他肾小球疾病患者48例和健康志愿者20名作为对照,采用酶联免疫吸附分析法检测上述对象血清IgA、补体C4、Gd-IgA1、CFH、CFHRP1、3、5浓度并行组间比较,绘制受试者工作特征曲线评估血清Gd-IgA1、Gd-IgA1/CFH、CFHRP1/CFH、CFHRP5/CFH在IgAN中的诊断价值,筛选出受试者工作特征曲线的曲线下面积较大的指标Gd-IgA1、CFHRP1/CFH、CFHRP5/CFH,重点研究Gd-IgA1分别联合检测CFHRP1/CFH、CFHRP5/CFH对IgAN的诊断价值。结果原发性IgAN组患者血清IgA[1.568(1.344,1.705)g/L比1.177(0.618,1.893)g/L、0.538(0.433,0.732)g/L]、补体C4[0.547(0.494,0.643)g/L比0.396(0.312,0.515)g/L、0.289(0.186,0.356)g/L]、Gd-IgA1[0.003(0.002,0.004)g/L比0.002(0.001,0.003)g/L、0.0017(0.0010,0.0020)g/L]、CFHRP1[0.013(0.011,0.015)g/L比0.010(0.009,0.013)g/L、0.011(0.009,0.012)g/L]水平及Gd-IgA1/CFH[0.023(0.017,0.030)比0.012(0.009,0.021)mmol/L、0.005(0.004,0.007)mmol/L]、CFHRP1/CFH[0.115(0.091,0.161)比0.093(0.061,0.108)、0.038(0.028,0.043)]比值明显高于其他肾小球疾病组和健康组(P<0.05),血清CFH[0.000109(0.000089,0.000110)g/L比0.000285(0.000259,0.000347)g/L]浓度低于健康组(P<0.05);血清Gd-IgA1联合CFHRP1/CFH、CFHRP5/CFH诊断原发性IgAN的曲线下面积分别为0.946(95%CI:0.908~0.985)、0.926(95%CI:0.874~0.978),灵敏度分别为80%、90%,特异度分别为93.9%、86.3%。结论Gd-IgA1联合检测CFHRP1/CFH、CFHRP5/CFH对于诊断原发性IgAN具有较好价值,或可作为诊断IgAN的潜在无创性生物标志物。
