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血清VEGF、CysC、RBP与慢性肾小球肾炎病理及预后的相关性分析

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目的 探讨血清血管内皮生长因子(VEGF)、半胱氨酸蛋白酶抑制剂C(CysC)、视黄醇结合蛋白(RBP)与慢性肾小球肾炎(CGN)病理及预后的相关性.方法 选取2020年6月至2022年8月诊治的102例CGN患者作为研究对象(观察组),根据病理类型将观察组再分为系膜增生性肾炎(MSPGN)组(n=35)、系膜毛细血管性肾小球肾炎(MPGN)组(n=23)、膜性肾病(MN)组(n=27)、局灶节段性肾小球硬化(FSGS)组(n=17).选取同期健康体检者(n=51)作为对照组.对比各组血清VEGF、CysC、RBP变化,采用Pearson法分析VEGF、CysC、RBP与病理积分的相关性.对所有患者随访12个月,根据其不同预后分为进展组(n=28)和无进展/缓解组(n=74).采用多因素Cox风险回归分析VEGF、CysC、RBP对CGN患者预后的影响;采用受试者操作特征(ROC)曲线分析VEGF、CysC、RBP及3项联合预测CGN患者预后的曲线下面积(AUC)、灵敏度及特异度.结果 观察组血清VEGF、CysC、RBP水平均高于对照组(P<0.05),且FSGS组VEGF、CysC水平高于其他3组(P<0.05),RBP水平高于MSPGN组(P<0.05).Pearson相关分析显示,VEGF、CysC、RBP水平与病理积分呈正相关(P<0.05).进展组VEGF、CysC、RBP均高于无进展/缓解组(P<0.05).多因素Cox风险回归分析显示,VEGF、CysC、RBP水平升高是影响CGN患者预后的危险因素(P<0.05).ROC曲线分析显示,VEGF、CysC、RBP及3项联合预测CGN患者预后的AUC值分别为0.828、0.844、0.760、0.940(P<0.05);灵敏度分别为75.00%、71.40%、57.10%、89.30%;特异度分别为93.20%、93.20%、95.90%、89.20%.结论 CGN患者血清VEGF、CysC、RBP水平升高,且与病理积分呈正相关,是影响患者预后的危险因素.
Correlation analysis of serum VEGF,CysC,and RBP with pathology and prognosis of chronic glomerulonephritis
Objective To investigate the correlation between serum vascular endothelial growth factor(VEGF),Cystatin C(CysC),and retinol-binding protein(RBP)levels and the pathology and prognosis of chronic glomerulonephritis(CGN).Methods A total of 102 patients with CGN diagnosed and treated between June 2020 and August 2022 were selected as study participants and assigned to the observation group,which was divided according to pathological types into the mesangial proliferative nephritis(MSPGN,n=35),mesangial capillary glomerulonephritis(MPGN,n=23),membranous nephropathy(MN,n=23),and focal segmental glomerulosclerosis(FSGS,n=17)groups.Healthy subjects(n=51)were selected as the control group.Changes in serum VEGF,CysC,and RBP levels were compared,and the correlation between VEGF,CysC,and RBP levels and pathological scores was analyzed using the Pearson method.All patients were followed up for 12 months and divided according to prognoses into a progression group(n=28)and no progression/remission group(n=74).The effects of VEGF,CysC,and RBP levels on the prognosis of patients with CGN were analyzed using Cox multifactor risk regression.The area under the curve(AUC),sensitivity,and specificity of VEGF,CysC,RBP,and the combined prognoses of patients with CGN were analyzed using a receiver operating characteristic(ROC)curve.Results The VEGF,CysC,and RBP levels were higher in the observation group than in the control group(P<0.05).The VEGF,and CysC,levels in the FSGS group were higher than those in the MSPGN,MPGN,and MN groups(P<0.05).The level of RBP in FSGS group was higher than that in MSPGN group(P<0.05).Pearson correlation analysis showed that VEGF,CysC,and RBP levels were positively correlated with the pathological scores(P<0.05).The VEGF,CysC,and RBP levels were higher in the progression group than in the no progression/remission group(P<0.05).Multivariate Cox regression analysis showed that increased VEGF,CysC,and RBP levels were risk factors for the prognosis of patients with CGN(P<0.05).The ROC curve analysis showed that the AUC values predicted by VEGF,CysC,RBP,and the combination of the three were 0.828,0.844,0.760,and 0.940,respectively(P<0.05);sensitivity was 75.00%,71.40%,57.10%,and 89.30%,respectively,and specificity was 93.20%,93.20%,95.90%,and 89.20%,respectively.Conclusion Serum VEGF,CysC,and RBP are highly expressed in patients with CGN,and high pathological scores are associated with increased levels,thus also affecting patient prognosis.

vascular endothelial growth factorCystatin Cretinol-binding proteinchronic glomerulonephritispathologyprognosis

洪丽萍、尤云、刘变玲、张珂

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郑州市金水区总医院肾病科,郑州 450003

信阳职业技术学院附属医院血液净化室,河南 信阳 464000

郑州人民医院肾内科,郑州 450000

郑州大学第二附属医院肾病科,郑州 450000

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血管内皮生长因子 半胱氨酸蛋白酶抑制剂C 视黄醇结合蛋白 慢性肾小球肾炎 病理 预后

河南省医学科技攻关计划联合共建项目

LHGJ20210400

2024

中国医科大学学报
中国医科大学

中国医科大学学报

CSTPCD北大核心
影响因子:1.421
ISSN:0258-4646
年,卷(期):2024.53(9)