IgA肾病中医证型与黏膜免疫相关性横断面研究
Cross-sectional Study on the Correlation Between Chinese Medicine Syndrome Types and Mucosal Immunity in IgA Nephropathy
成庭柱 1任翼 2杜亚婷 1冯雪 3孙士鹏 3饶向荣 1李深1
作者信息
- 1. 中国中医科学院广安门医院肾病科(北京 100053)
- 2. 首都医科大学附属北京友谊医院中医科(北京 100050)
- 3. 中国中医科学院广安门医院检验科(北京 100053)
- 折叠
摘要
目的 探讨IgA肾病(IgAN)患者中医证候分型及与黏膜免疫的相关性.方法 采用横断面研究方法,纳入IgAN患者410例,收集患者中医证候资料,运用因子分析及聚类分析方法,总结中医证候分类.对其中118例患者血清低半乳糖基化IgA1(Gd-IgA1)及黏膜免疫相关标志物:B细胞活化因子(BAFF)、增殖诱导配体(APRIL)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)进行检测,分析不同中医证候患者血清Gd-IgA1含量及其与上述黏膜免疫相关标志物的相关性.结果 共采集51个与IgAN证候紧密相关的症状、舌象及脉象,提取13个特征根＞1的公因子,聚类为4类.将IgAN患者的中医证候归类为肺脾气虚证186例(45.36％),肝肾阴虚证102例(24.88％),脾肾阳虚证79例(19.27％),肝气郁滞证 43 例(10.49％).肺脾气虚证患者 Gd-lgA1 含量为 6.09(4.44,7.00)μg/mL,高于其他中医证型患者(P＜0.01).伴有不同部位黏膜炎症的IgAN患者Gd-lgA1含量较不伴有黏膜炎症的患者升高(P＜0.01).IgAN患者Gd-lgA1含量与黏膜免疫相关标志物APRIL、IL-6、TNF-α具有相关性(P＜0.05).结论 IgAN患者临床常见证型为肺脾气虚证、肝肾阴虚证、脾肾阳虚证、肝气郁滞证,肺脾气虚证与黏膜免疫异常关系最密切.
Abstract
Objective To explore the Chinese medicine(CM)syndrome classification and its correlation with mucosal immunity in patients with IgA nephropathy(IgAN).Methods A cross-sectional study was performed,including 410 patients with IgAN.The data of CM syndrome were collected,and the CM syndrome classification was summarized by factor analysis and cluster analysis.Serum levels of galactose-deficient IgA1(Gd-IgA1)and mucosal immune-related markers,including B cell activating factor(BAFF),a proliferation inducing ligand(APRIL),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were measured in 118 patients.The correlation between serum Gd-IgA1 levels in different CM syndromes and these mucosal immune-related markers was analyzed.Results A total of 51 symptoms,tongue images and pulse images closely related to IgAN syndromes were collected,and 13 common factors with eigenvalues greater than 1 could be extracted,which could be clustered into 4 categories.The CM syndromes of IgAN patients were classified as Fei-Pi qi-deficiency syndrome in 186 cases(45.36％),Gan-Shen yin-deficiency syndrome in 102 cases(24.88％),Pi-Shen yang-deficiency syndrome in 79 cases(19.27％),and Gan qi depression syndrome in 43 cases(10.49％).The serum Gd-IgA1 levels of patients with Fei-Pi qi-deficiency syndrome was 6.09(4.44,7.00)µg/mL,which was significantly higher than that of patients with other CM syndromes(P＜0.01).Gd-IgA1 levels were elevated in patients with IgAN at different sites of mucosal inflammation compared with patients without mucosal inflammation(P＜0.01).Serum Gd-IgA1 levels in IgAN patients demonstrated correlations with mucosal immune-related markers APRIL,IL-6 and TNF-α(P＜0.05).Conclusions The prevalent clinical CM syndromes in IgAN patients are Fei-Pi qi-deficiency syndrome,Gan-Shen yin deficiency syndrome,Pi-Shen yang-deficiency syndrome,and Gan qi depression syndrome.Fei-Pi qi-deficiency syndrome is most closely associated with abnormal mucosal immunity in IgAN.
关键词
IgA肾病/中医证候/黏膜免疫/低半乳糖基化lgA1/中西医结合Key words
IgA nephropathy/Chinese medicine syndrome/mucosal immunity/Galactose-deficient IgA1/integrative medicine引用本文复制引用
基金项目
国家自然科学基金(81573791)
首都临床特色应用研究项目(Z181100001718123)
出版年
2024
国家科技期刊平台
NSTL
万方数据