转化生长因子-β1在原发性IgA肾病病情预测中的价值

Prognostic Values of Transforming Growth Factor-β1 in Patients with Primary Immunoglobulin A Nephropathy

目的：探讨转化生长因子-β1（TGF-β1）在原发性IgA肾病患者中的动态变化及其在病情判断中的价值。方法：ELISA法动态检测42例原发性IgA肾病的血清TGF-β1浓度，绘制受试者工作特征曲线（ROC）、计算MPV的曲线下面积（AUC）。根据病理Lee分级分为轻度组（Ⅰ~Ⅲ级，27例）和重度组（Ⅳ~Ⅴ级，15例），另设30例同期住院的非IgA肾病作为对照组。结果：原发性IgA肾病患者入院时血清TGF-β1浓度较对照组显著高（t=6.18，P〈0.01），重度组显著高于轻度组（t=4.80，P〈0.01）。动态监测显示重度组于发病后表现为持续高值、轻度组高值持续时间较短且逐渐下降。原发性IgA肾病患者血清TGF-β1浓度的AUC为0.753，根据ROC曲线初步得血清TGF-β1浓度高于27.84pg/ml可预测原发性IgA肾病病情。结论：血清TGF-β1对原发性IgA肾病病情有阳性预测价值。

Objective：To explore the dynamical changes and prognostic values of transforming growth factor-β1（TGF-β1） in patients with primary immunoglobulin A nephropathy（IgAN）.Method：The serum TGF-β1 concentration in 42 patients with IgAN were dynamically tested by using ELISA.The receiver operating characteristic（ROC） curve was drawn and the area under curve（AUC） was compared.According to the Lee pathological grading,the cases were divided into mild group（ⅠtoⅢ,27 cases） and severe group（ⅣtoⅤ,15 cases）.In addition,30 homeochronous inpatients with non-IgAN were set up the（control group）.Result：The serum TGF-β1 concentration in patients with primary IgAN was higher than that in the control group,there was significant difference between two groups（t=6.18,P〈0.01）.Compared with the mild group,the serum TGF-β1 concentration in severe group increased significantly（t=4.80,P〈0.01）. Dynamic testing showed higher levels of long duration and in severe group,higher levels of short duration and decreasing gradually in mild group.ROC curve showed the AUC of serum TGF-β1 levels in patients with primary IgAN was 0.753.According to ROC curve,we derived serum TGF-β1 concentration〉27.84 pg/ml to predict patients,pathogenetic condition.Conclusion：The serum TGF-β1 can accurately predict pathogenetic condition in patients with primary IgAN.