摘要
目的探讨在重症IgA肾病患者中IL-4、C1GALT1及COSMC的mRNA表达及潜在预后因素对疾病及其预后的调控作用。方法选取本院ICU的重症确诊IgA患者61名,同时选取年龄性别可比的体检健康者65名作为对照,并使用荧光定量PCR测定外周血的单核细胞IL-4、C1GALT1以及COSMC的mRNA表达,同时问卷收集可能影响预后的相关因素,IgA患者随访5年,以随访结束时出现终末期肾病为预后不佳进行研究分析。对相关因素对本病预后的调控作用进行分析讨论。患者均知情同意并签署知情同意书。统计分析采用卡方检验以及t检验对一般资料及两组基因表达进行比较,使用多因素Logistics回归模型进行预后因素讨论,使用SPSS17.0统计软件包进行数据分析。结果 IgA患者组IL-4mRNA的表达水平为3.67±0.34,显著高于对照组的1.62±0.16;IgA组的C1GALT1 mRNA以及COSMC mRNA表达水平分别为1.42±0.22和1.34±0.13,出现相应的表达降低;对照组分别为1.61±0.22和1.63±0.18。对ICU重症IgA肾病患者进行预后分析,单因素分析结果提示IL-4表达增加在预后不良者中的构成显著高于预后良好者,P<0.05,肾病家族史构成比例在预后不良者中也明显较高。多因素Logistic回归结果提示年龄大于60岁、肌酐超标、高血压、肾病家族史以及IL-4 mRNA表达增加和C1GALT1 mRNA表达减低均为IgA肾病不良预后的危险因素。结论 ICU重症IgA肾病患者IL-4 mRNA表达增加,同时可见相应的C1GALT1 mRNA以及COSMC mRNA表达减低,且这三个因素与高龄、肌酐异常、高血压等因素同为重症IgA的预后不良因素。
Objective To study the expression of IL-4,C1GALT1 and COSMC mRNA in patients with severe IgA nephropathy（ IgAN） and other potential prognostic factors of the disease. Methods A total of 61 patients with severe IgAN and 65 controls with good match in age and gender were selected. Quantitative PCR assay was used to analyze mRNA expression of IL-4,C1GALT1 and COSMC. Questionnaires were sent out to collect potentially relevant prognostic factors. Patients were followed for 5 years,the poor prognosis was based on end-stage renal disease（ ESRD）. Statistical analysis was performed by chi-square test and t-test.Gene expression was compared by multivariate regression model Logistics prognostic factors using SPSS17. 0statistical package. Results The expression of IL-4 mRNA in the IgA patients was 3. 67 ± 0. 34,significantly higher than the 1. 62 ± 0. 16 for controls. C1GALT1 mRNA and COSMC mRNA were 1. 42 ± 0. 22 and1. 34 ± 0. 13 in IgA pantients,controls were 1. 61 ± 0. 22 and 1. 63 ± 0. 18. The prognosis analysis showed that IL-4 expression was higher in poor prognosis in patients with severe IgA nephropathy than those who had good prognosis（ P〈0. 05）. Family history of kidney disease had higher proportion of poor prognosis.Multivariate Logistic regression results suggested that older than 60 year-old,abnormal creatinine,high blood pressure,family history of kidney disease, as well as increased IL-4 mRNA expression and reduced C1GALT1 mRNA expression were poor prognostic risk factors IgA nephropathy. Conclusion Patients withsevere IgA nephropathy in ICU could have increased IL-4 mRNA expression,reduced C1GALT1 mRNA and COSMC mRNA expression. Poor prognostic factors include age,creatinine level,hypertension and others.
作者
邵江炜
SHAO Jiang- wei(Department of Emergency and Critical Care Medicine, Huashan Hospital Affiliated to Fudan University, Shanghai 201906, China)
出处
《标记免疫分析与临床》
CAS
2016年第12期1375-1378,共4页
Labeled Immunoassays and Clinical Medicine
