探讨sPD-1和sPD-L1在原发性肾病综合征患者中的表达及其临床意义

Expression and its clinical significance of sPD-1 and sPD-L1 in patients with primary nephrotic syndrome

目的探讨可溶性程序性死亡蛋白1(soluble programmed death protein 1,sPD-1)、可溶性程序性死亡蛋白配体1(soluble programmed death protein ligand 1,sPD-L1)在原发性肾病综合征(primary nephrotic syndrome,PNS)患者中的表达及其临床意义。方法选择2016年4月至2019年4月我院收治的PNS患者87例作为病例组,同期在我院健康体检者87例作为对照组,比较两组血清sPD-1、sPD-L1水平,比较不同病理类型PNS患者血清sPD-1、sPD-L1水平,比较不同转归情况PNS患者血清sPD-1、sPD-L1水平,采用P earson相关分析PNS患者血清sPD-1、sPD-L1水平的相关性,采用多因素Logistic回归分析PNS发生的危险因素。结果病例组治疗前血清sPD-1、sPD-L1水平明显高于对照组,差异具有统计学意义(P<0.05);3种病理类型的PNS患者治疗前血清sPD-1、sPD-L1水平差异具有统计学意义(P<0.05);3种病理类型的PNS患者治疗后血清sPD-1、sPD-L1水平差异具有统计学意义(P<0.05);3种病理类型的PNS患者治疗前、后血清sPD-1、sPD-L1水平差异均具有统计学意义(P<0.05);不同转归情况PNS患者治疗后血清sPD-1、sPD-L1水平差异具有统计学意义(P<0.05);PNS患者血清sPD-1、sPD-L1水平呈正相关(P<0.05);sPD-1、sPD-L1是PNS的影响因素(P<0.05)。结论sPD-1、sPD-L1在原发性肾病综合征患者血清中呈高表达,sPD-1、sPD-L1检测对肾病综合征预后评估有潜在价值。

Objective To investigate expression and its clinical significance of soluble programmed death protein 1(sPD-1)and soluble programmed death ligand 1(sPD-L1)in patients with primary nephrotic syndrome(PNS).Methods A total of 87 PNS patients admitted to our hospital from April 2016 to April 2019 were selected as the case group,and 87 healthy volunteers receiving physical examinations in our hospital in the same period were used as the control group.Comparison of serum sPD-1 and sPD-L1 levels were conducted between the two groups,between different pathological types of PNS patients,and between PNS patients with different outcomes.Pearson correlation analysis was used to determine the correlation of serum sPD-1 and sPD-L1 levels in patients with PNS,and multivariate logistic regression was used to analyze the risk factors of PNS.Results Before treatment,the serum levels of sPD-1 and sPD-L1 in the case group were significantly higher than those in the control group(P<0.05).The levels of serum sPD-1 and sPD-L1 showed significant difference among three pathological types of PNS patients before treatment(P<0.05).The levels of serum sPD-1 and sPD-L1 showed significant difference among three pathological types of PNS patients after treatment(P<0.05).There were significant differences in serum sPD-1 and sPD-L1 levels between the three pathological types of PNS patients before and after treatment(P<0.05).The serum levels of sPD-1 and sPD-L1 in PNS patients with different outcomes were significantly different after treatment(P<0.05).Serum levels of sPD-1 and sPD-L1 were positively correlated in patients with PNS(P<0.05);sPD-1 and sPD-L1 were independent risk factors for PNS(P<0.05).Conclusions sPD-1 and sPD-L1 are highly expressed in the serum of PNS patients,therefore,the detection of the two indices is of vital importance for the treatment and prognosis evaluation.