老年慢性肾小球肾炎病人血清Ficolin-3水平与肾功能损害程度及预后的关系

doi:10.3969/j.issn.1003-9198.2023.01.007

摘要/Abstract

摘要： 目的探究老年慢性肾小球肾炎(CGN)病人血清纤维胶凝蛋白-3(Ficolin-3)水平与肾功能损害程度及预后的关系。方法选取2017年9月至2019年9月本院收治的140例老年CGN病人(CGN组)进行研究,并纳入同期140例老年健康体检者(对照组)进行对照研究。比较2组一般资料及血清Ficolin-3水平。根据估算肾小球滤过率(eGFR)水平将140例CGN病人分为3组,即正常-轻度下降组(43例)、中度下降组(57例)、重度下降组(40例)。对病人随访2年,其中发展成慢性肾功能衰竭(CRF)10例(CRF组),病情缓解/无进展130例(非CRF组)。采用Pearson相关系数描述CGN病人血清Ficolin-3水平与肾功能指标UA、BUN、血肌酐(SCr)的相关性;绘制ROC曲线分析血清Ficolin-3水平及肾功能指标对CGN病人CRF的评估价值;多因素Cox回归分析CGN病人CRF发生的影响因素。结果 CGN组病人UA、BUN、SCr及血清Ficolin-3水平明显高于对照组(P<0.01)。不同水平肾功能病人UA、BUN、SCr及血清Ficolin-3水平由高至低依次为重度下降组、中度下降组和正常-轻度下降组(P<0.05)。CGN病人血清Ficolin-3水平与UA、BUN、SCr水平均呈正相关(r=0.559、0.394、0.427,P<0.05)。CRF组病人UA、BUN、SCr及血清Ficolin-3水平明显高于非CRF组(P<0.05或P<0.01)。血清Ficolin-3联合肾功能指标评估CGN病人发生CRF的AUC为0.944,明显高于Ficolin-3、UA、BUN、SCr单独检测(P<0.05)。Cox回归分析显示,BUN≥9.07 mmol/L、SCr≥88.64 μmol/L、Ficolin-3≥45.02 mg/L是CGN病人发生CRF的危险因素(P＜0.05)。结论老年CGN病人血清Ficolin-3水平升高,高水平的Ficolin-3与CGN病人肾功能损害程度及预后有关。

关键词: 纤维胶凝蛋白-3, 老年人, 慢性肾小球肾炎, 肾功能, 预后

Abstract: Objective To explore the relationship of the level of serum Ficolin-3 with the degree of renal function damage and the prognosis in the elderly patients with chronic glomerulonephritis (CGN). Methods A total of 140 elderly patients with CGN (CGN group) in our hospital from September 2017 to September 2019 and 140 elderly healthy people (control group)were enrolled in this study. The general data and the level of serum Ficolin-3 of the two groups were observed and compared. According to the estimated glomerular filtration rate (eGFR), the patients with CGN were divided into three groups: normal/mild decline group (43 cases), moderate decline group (57 cases) and severe decline group (40 cases). The patients were followed up for 2 years, of which 10 cases presented with chronic renal failure (CRF) (CRF group) and 130 cases showed remission/no progress (non-CRF group). Pearson correlation analysis was used to analyze the relationship of serum ficolin-3 with renal function indexes such as uric acid (UA), urea nitrogen (BUN) and serum creatinine (SCr) in patients with CGN; Receiver operating characteristic(ROC)curve was used to analyze the value of serum Ficolin-3 and renal function indexes in the evaluation of CRF in the patients with CGN; Multivariate Cox regression analysis was used to analyze the influencing factors of CRF. Results The levels of UA, BUN, SCr and serum Ficolin-3 in CGN group were significantly higher than those in control group (P<0.01). The levels of UA, BUN, SCr and serum Ficolin-3 were the highest in severe decline group, followed by moderate decline group and normal mild decline group (P<0.05). The level of serum Ficolin-3 in the patients with CGN was positively correlated with UA, BUN and SCr (r=0.559,0.394,0.427,P<0.05). The levels of UA, BUN, SCr and serum Ficolin-3 in CRF group were significantly higher than those in non-CRF group (P<0.05). The area under the curve (AUC) of serum Ficolin-3 combined with the renal function indexes in the evaluation of CRF in patients with CGN was 0.944, which was significantly higher than that of Ficolin-3, UA, BUN and SCr alone (P<0.05). BUN ≥ 9.07 mmol/L, SCr ≥ 88.64 μmol/L and Ficolin-3 ≥ 45.02 mg/L were the risk factors of CRF in the patients with CGN (P<0.05). Conclusions The level of serum Ficolin-3 in the elderly patients with CGN is high, and it is related to the degree of renal function damage and the prognosis in the patients with CGN.

Key words: Ficolin-3, aged, chronic glomerulonephritis, renal function, prognosis

中图分类号:

R 692.31

周梅, 汤义兵, 曹雷, 邵云侠. 老年慢性肾小球肾炎病人血清Ficolin-3水平与肾功能损害程度及预后的关系[J]. 实用老年医学, 2023, 37(1): 26-30.

ZHOU Mei, TANG Yi-bing, CAO Lei, SHAO Yun-xia. Relationship of serum Ficolin-3 level with degree of renal function damage and prognosis in elderly patients with chronic glomerulonephritis[J]. Practical Geriatrics, 2023, 37(1): 26-30.

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