摘要
目的 分析载脂蛋白B(apoB)/载脂蛋白A1(apoA1)对狼疮肾炎(LN)和肾功能不全的影响及其诊断价值.方法 选取2019年7月至2023年1月间在安徽中医药大学附属太和县中医院诊断的系统性红斑狼疮(SLE)患者134例并分为LN组(n=82)和单纯SLE组(n=52).根据肾小球滤过率(e-GFR),将LN分为肾功能正常组(n=42)和肾功能不全组(n=40).比较不同组别间临床资料的差异,并分析apoB、apoA1、apoB/apoA1对LN及肾功能不全的诊断价值.结果 二元logistic回归分析结果显示,apoB/apoA1、SLE疾病活动指数(SLEDAI)、抗双链DNA(dsDNA)、补体3(C3)、白蛋白(ALB)为 LN 独立影响因素(OR=4.033、1.179、3.148、0.374、0.879,均P＜0.05).apoB、apoA1、apoB/apoA1诊断 LN 的曲线下面积(AUC)分别为 0.623、0.662、0.742.apoB/apoA1诊断效能高于apoB、apoA1,差异均有统计学意义(均P＜0.05).无论是否校正混杂因素,apoB/apoA1均为e-GFR＞60 ml/(min·1.73 m2)、e-GFR 30～60 ml/(min·1.73 m2)、e-GFR＜30 ml/(min·1.73 m2)LN的风险因素(均P＜0.05).apoB/apoA1、抗-dsDNA、C3、ALB均为肾功能不全LN的独立影响因素(OR=3.778、2.669、0.415、0.884,均 P＜0.05).apoB、apoA1、apoB/apoA1 诊断肾功能不全 LN 的AUC分别为0.623、0.640、0.730.apoB/apoA1诊断效能高于apoB、apoA1,差异均有统计学意义(均P＜0.05).结论 apoB/apoA1为LN以及肾功能不全LN发生的独立影响因素,且对LN以及肾功能不全LN有较好的诊断价值.
Abstract
Objective To analyze the impact and diagnostic value of apoB/apoAl on lupus nephritis(LN)and its renal dysfunction.Methods A total of 134 patients diagnosed with systemic lupus erythematosus(SLE)at the Taihe Hospital of Anhui University of Traditional Chinese Medicine from July 2019 to January 2023 were selected and divided into LN group(n=82)and simple SLE group(n=52).According to the glomerular filtration rate(e-GFR),LN was divided into a group with normal renal function(n=42)and a group with renal insufficiency(n=40).We compared the differences in clinical data between different groups and analyzed the diagnostic value of apoB,apoA1,and apoB/apoA1 for LN and its renal insufficiency.Results The results of binary logistic regression analysis showed that apoB/apoA1,SLE disease activity index(SLEDAI),anti double stranded DNA(dsDNA),complement 3(C3),and albumin(ALB)were independent influencing factors for LN(OR=4.033,1.179,3.148,0.374,0.879,all P＜0.05).The area under the curve(AUC)of apoB,apoA1,and apoB/apoA1 for diagnosing LN were 0.623,0.662,and 0.742,respectively.The diagnostic efficacy of apoB/apoA1 was higher than that of apoB and apoA1,and the differences are statistically significant(all P＜0.05).Regardless of whether confounding factors were adjusted or not,apoB/apoA 1 were all risk factors for LN with e-GFR＞60 ml/(min·1.73 m2),e-GFR 30-60 ml/(min·1.73 m2),and e-GFR＜30 ml/(min·1.73 m2)(all P＜0.05).ApoB/apoA1,anti dsDNA,C3,and ALB were all independent influencing factors for renal insufficiency LN(OR=3.778,2.669,0.415,0.884,all P＜0.05).The AUC for diagnosing renal insufficiency LN in apoB,apoA1,and apoB/apoA1 were 0.623,0.640,and 0.730,respectively.The diagnostic efficacy of apoB/apoA1 was higher than that of apoB and apoA1,and the differences were statistically significant(all P＜0.05).Conclusions ApoB/apoA1 is an independent influencing factor for the occurrence of LN and renal insufficiency LN,and has good diagnostic value for LN and renal insufficiency LN.
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