补体因子H、补体因子H相关蛋白在IgA肾病诊断中的应用价值

Value of complement factor H and complement factor H related proteins in diagnosis of IgA nephropathy

目的探讨血浆补体因子H(CFH)和补体因子H相关蛋白(CFHRP) 1、CFHRP 5在Ig A肾病(Ig AN)诊断中的价值。方法选取疑似Ig AN患者157例,另选取60例健康体检者作健康对照组。对157例疑似Ig AN患者均在B超引导下行肾活检术,以肾组织病理检查结果为确诊Ig AN的金标准。收集受试者晨血2 m L,采用酶联免疫吸附(ELISA)法检测血浆CFH、CFHRP1、CFHRP5水平。绘制受试者工作特征(ROC)曲线,计算血浆CFH、CFHRP1、CFHRP5诊断灵敏度和特异度,通过比较ROC曲线下面积(AUC)来判断上述三种指标对Ig AN的诊断价值。结果经肾组织病理检查,确诊Ig AN(Ig AN组) 89例、其他肾脏疾病(其他肾脏疾病组) 68例。Ig AN组血浆CFH水平低于其他两组,血浆CFHRP1、CFHRP5水平均高于其他两组(P均<0. 05)。血浆CFH、CFHRP1、CFHRP5诊断Ig AN的灵敏度分别为85%、69%、60%,特异度分别为71%、77%、71%; ROC曲线显示上述三种指标的AUC均大于0. 7,其中CFH的AUC最大(0. 862)。结论血浆CFH、CFHRP1、CFHRP5对诊断Ig A肾病均具有一定价值,其中CFH的诊断价值较高。

Objective Objective To investigate the value of plasma complement factor H(CFH)and complement factor H-related protein(CFHRP)1and CFHRP5in the diagnosis of IgA nephropathy(IgAN).Methods Totally157patients with suspected IgAN were selected,and60healthy subjects were selected as healthy controls.All157patients with suspected IgAN underwent B-guided renal biopsy,and the results of renal histopathology were used as the gold standard for the diagnosis of IgAN.The morning blood(2mL)was collected,and the levels of CFH,CFHRP1,and CFHRP5in the plasma were detected by enzyme-linked immunosorbent assay(ELISA).The receiver operating characteristic(ROC)curve was drawn to calculate the diagnostic sensitivity and specificity of plasma CFH,CFHRP1,and CFHRP5.The diagnostic value of the above three indicators for IgAN was judged by comparing the area under the ROC curve(AUC).Results According to renal pathological examination,89cases of IgAN(IgAN group)and68cases of other kidney diseases(other kidney disease group)were diagnosed.The plasma CFH levels in the IgAN group were lower than those in the other two groups,and plasma CFHRP1and CFHRP5levels were higher than those of the other two groups(all P<0.05).The sensitivities of plasma CFH,CFHRP1,and CFHRP5in the diagnosis of IgAN were85%,69%,and60%,respectively,and the specificities were71%,77%,and71%.The ROC curve showed that the AUC of the above three indexes were all greater than0.7,of which CFH AUC was the largest(0.862).Conclusion Plasma CFH,CFHRP1,and CFHRP5have certain value in the diagnosis of IgA nephropathy,and the diagnostic value of CFH is higher.