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原发性肾病综合征儿童尿液CD80表达水平对临床预后价值研究

Clinical Prognostic Value of Urinary CD80 Expression in Children with Primary Nephrotic Syndrome
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摘要 目的探讨尿CD80在原发性肾病综合征(primary nephrotic syndrome,PNS)患儿中的表达水平及其对预后的影响。方法选择2016年1月~2017年12月宜宾市第一人民医院收治的73例PNS患儿为病例组,根据病理类型分为膜性肾病组(MN组,n=41)、微小病变肾病组(MCD组,n=32),并于同期随机选取40例健康体检儿童为对照组。检测并比较各组尿CD80,24h尿蛋白、血肌酐(SCr)和血尿素氮(BUN)水平,计算并比较肾小球滤过率估计值(eGFR)。采用Pearson积矩相关分析法分析尿CD80与SCr,BUN,24h尿蛋白和eGFR的相关性。受试者工作特征(ROC)曲线分析尿CD80对MN组和MCD组的鉴别诊断价值。采用Kaplan-Meier生存曲线分析尿CD80与MN组和MCD组患儿肾损伤进展的关系。结果病例组SCr(135.72±25.86μmol/L),BUN(8.52±3.19mmol/L),24h尿蛋白(3.79±1.24g/24h)和尿CD80(503.75±86.24ng/g)水平高于对照组(49.18±23.04μmol/L,3.51±2.67mmol/L,1.12±0.95g/24h,129.22±77.13ng/g),差异均有统计学意义(t=17.662,8.416,11.823,22.901,均P<0.05);eGFR水平低于对照组(92.39±18.51ml/min/1.73m^(2)vs 145.72±20.41ml/min/1.73m^(2)),差异有统计学意义(t=14.129,P<0.05)。MCD组患儿SCr(167.25±28.61μmol/L),BUN(9.82±3.64mmol/L),24h尿蛋白(6.21±1.38g/24h)和尿CD80(623.50±92.31ng/g)水平高于MN组(105.49±24.17μmol/L,7.51±4.02mmol/L,2.43±1.19g/24h,358.12±85.46ng/g),差异均有统计学意义(t=9.993,2.546,12.556,12.715,均P<0.05);eGFR水平低于MN组(78.05±22.90ml/min/1.73m^(2)vs 118.67±18.03ml/min/1.73m^(2)),差异有统计学意义(t=8.483,P<0.05)。Pearson积矩相关分析,MN组、MCD组尿CD80与SCr,BUN和24h尿蛋白均呈正相关性(r=0.392~0.649,均P<0.05),与eGFR呈负相关性(r=-0.579,-0.593,均P<0.05)。ROC曲线结果显示,尿CD80鉴别诊断MN组和MCD组的AUC为0.811(95%CI:0.785~0.839),截断值为492.65ng/g,约登指数为0.59,敏感度和特异度分别为81.25%,78.05%。尿CD80<352.76ng/g的MN组患儿未发生慢性肾病综合征(chronic kidney disease,CKD)的中� Objective To investigate the expression level of urinary CD80 in children with primary nephrotic syndrome(PNS)and its predictive value for prognosis.Methods A total of 73 children with PNS admitted to the First People’s Hospital of Yibin from January 2016 to December 2017 were selected as the case group.According to the pathological type.They were divided into membranous nephropathy group(MN group,n=41)and minimal change nephropathy group(MCD group,n=32),and 40 healthy children were randomly selected as the control group during the same period.Urine CD80,24h urinary protein,serum creatinine(SCr)and blood urea nitrogen(BUN)levels were detected and compared in each group,and estimated glomerular filtration rate(eGFR)was calculated.The correlation between urinary CD80 and SCr,BUN,24h urinary protein and eGFR was analyzed by Pearson product-moment correlation analysis.The receiver operating characteristic(ROC)curve was used to analyze the differential diagnosis value of urinary CD80 for MN and MCD.After 3 years of follow-up,Kaplan-Meier survival curve was used to analyze the relationship between urinary CD80 and the progression of renal injury in children with MN and MCD.Results The levels of SCr(135.72±25.86μmol/L),BUN(8.52±3.19mmol/L),24h urinary protein(3.79±1.24g/24h),and urinary CD80(503.75±86.24ng/g)in the case group were higher than those in the control group(49.18±23.04μmol/L,3.51±2.67mmol/L,1.12±0.95g/24h,129.22±77.13ng/g),and the differences were statistically significant(t=17.662,8.416,11.823,22.901,all P<0.05).The eGFR level was lower than that of the control group(92.39±18.51ml/min/1.73m^(2) vs 145.72±20.41ml/min/1.73m^(2)),and the difference was statistically significant(t=14.129,P<0.05).The levels of SCr(167.25±28.61μmol/L),BUN(9.82±3.64mmol/L),24h urinary protein(6.21±1.38g/24h)and urinary CD80(623.50±92.31ng/g)in the MCD group were higher than those of MN group(105.49±24.17μmol/L,7.51±4.02mmol/L,2.43±1.19g/24h,358.12±85.46ng/g),and the differences were statistically significan
作者 赵晶 袁腾英 付强 ZHAO Jing;YUAN Teng-ying;FU Qiang(Department of Pediatrics,the First People’s Hospital of Yibin,Sichuan Yibin 644000,China)
出处 《现代检验医学杂志》 CAS 2023年第2期102-106,135,共6页 Journal of Modern Laboratory Medicine
基金 四川省卫生和计划生育委员会科研课题(编号:150255)。
关键词 原发性肾病综合征 膜性肾病 微小病变肾病 CD80 primary nephrotic syndrome membranous nephropathy minimal change nephropath CD80
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