补体B因子与特发性膜性肾病的相关性研究

Correlation between complement B factor and idiopathic membranous nephropathy

目的 研究补体B因子(complement factor B,CFB)与特发性膜性肾病(idiopathic membranous nephropathy, IMN)的相关性。方法 选取2019年8月~2020年12月于哈尔滨医科大学附属第一医院肾内科接受肾活检穿刺,根据病理被诊断为IMN的患者32例(根据有无肾小球硬化分为肾小球硬化组18例和无肾小球硬化组14例,根据病理分期分为Ⅰ期10例、Ⅱ期15例、Ⅲ~Ⅳ期7例)、非IMN28例,同时从哈尔滨医科大学附属第一医院体检中心随机抽取12例健康人作为正常组。应用酶联免疫吸附法测定血、尿CFB水平,比较IMN组、非IMN组和正常组血、尿CFB的差异,分析血、尿CFB水平与特发性膜性肾病疾病严重程度的关系。结果 血清CFB的最佳截断值为2.93 g/L,灵敏度和特异性分别为0.844和0.9;尿CFB的最佳截断值为2.95 g/L,灵敏度和特异性分别为0.938和0.9;与正常组和非IMN组相比,IMN组血清和尿CFB水平升高(P<0.05),各组间血清和尿CFB水平比较,差异无统计学意义(P>0.05);IMN组血清CFB水平与24 h尿蛋白水平呈正相关(P<0.05),而尿CFB水平与24 h尿蛋白水平相关性无统计学意义(P>0.05);IMN组中肾小球硬化较无肾小球硬化血CFB水平低,而尿CFB水平高,但差异无统计学意义(P>0.05);IMN组病理分期Ⅰ期较Ⅱ期血CFB水平升高(P<0.05)。结论 血、尿CFB与特发性膜性肾病具有相关性,可以用来辅助诊断特发性膜性肾病。

Objective To study the correlation between complement factor B(CFB) and idiopathic membranous nephropathy(IMN). Methods The patients who underwent renal biopsy in the Department of Nephrology, the First Affiliated Hospital of Harbin Medical University from August 2019 to December 2020 were selected. According to pathology, 32 cases were diagnosed as IMN and 28 cases were diagnosed as non-IMN. Twelve healthy people were selected randomly as the normal group from the physical examination center. According to the presence or absence of glomerulosclerosis, 32 IMN cases were divided into glomerulosclerosis group with 18 cases and non-glomerulosclerosis group with 14 cases. According to pathological stage, they were divided into 10 cases in stage Ⅰ, 15 cases in stage Ⅱ, and 7 cases in stage Ⅲ~Ⅳ. The immunoadsorption method was used to measure the levels of CFB in blood and urine. The differences of blood and urine CFB in the IMN group, non-IMN group and the normal group were compared, and the relationship between the level of CFB in blood and urine and the severity of idiopathic membranous nephropathy were analyzed. Results The optimal cut-off value of serum CFB was 2.93 g/L, and the sensitivity and specificity were 0.844 and 0.9, respectively. The optimal cut-off value of urinary CFB was 2.95 g/L, and the sensitivity and specificity were 0.938 and 0.9, respectively. Compared with normal group and non-IMN group, serum and urine CFB levels in IMN group were increased(P<0.05). There was no statistical significance in serum and urine CFB levels among all groups(P>0.05). Serum CFB level was positively correlated with 24 h urinary protein level in IMN group(P<0.05), while there was no statistical significance between CFB level and 24 h urinary protein level(P>0.05). The level of blood CFB in IMN group was lower than that in the absence of glomerulosclerosis, but the level of urine CFB was higher. The difference was not statistically significant(P>0.05). The level of blood CFB in IMN group at pathological stage Ⅰ was higher than that at stage Ⅱ(P<0.05). Conclusion Blood and urine CFB is correlated with idiopathic membranous nephropathy, and can be used to assist in the diagnosis of idiopathic membranous nephropathy.