IgA肾病患者肠黏膜屏障功能与血清Gd-IgA1相关性研究

The Correlation of Intestinal Mucosal Barrier Function with Serum Gd-IgA1 in Patients with IgA Nephropathy

目的探讨肠黏膜屏障功能与血清Gd-IgA1表达水平的相关性。方法收集2019年1月~2019年12月我科住院病人,以首次经肾活检证实为IgA肾病患者45例作为IgA肾病组,以正常健康人群25例作为对照组。检测所有血清样本中炎症因子水平(IL-6及TNF-α)、肠黏膜屏障损伤指标(D-LAC、DAO、sICAM-1及LPS)及Gd-IgA1水平,同时收集患者的一般资料及临床指标(肾功能、24 h尿蛋白定量及IgA水平),并对上述指标进行统计学分析。结果与对照组相比,实验组患者炎症因子水平、肠道黏膜屏障损伤指标及Gd-IgA1水平升高,差异具有统计学意义(P<0.05),并且实验组患者血清Gd-IgA1水平与肠道屏障损伤指标呈正相关(P<0.05)。结论IgA肾病患者血清Gd-IgA1水平升高,肠黏膜屏障功能可能参与了Gd-IgA1的表达,这为IgA肾病的治疗监测及判断预后开拓新方向。

Objective To explore the correlation between intestinal mucosal barrier damage index and serum Gd-IgA1 expression levels.Methods In our retrospective review from January 2019 to December 2019,45 patients with IgA nephropathy(IgAN)confirmed by renal biopsy for the first time were enrolled as the IgA nephropathy group and 25 healthy individuals in the Physical Examination Center of our hospital as the control group.The levels of inflammatory factors(TNF-αand IL-6),intestinal mucosal barrier damage index(DAO,D-LAC,sICAM-1 and LPS)and Gd-IgA1 levels were examined in all serum samples,and the general data,renal function,24 h urine protein quantification,and IgA levels of the patients were collected for statistical analysis.Results Compared with the healthy controls,inflammatory factors,intestinal mucosal barrier damage index and Gd-IgA1 levels were significantly higher in patients with IgAN(P<0.05),and serum Gd-IgA1 levels in IgAN were positively associated with them(P<0.05).Conclusion The impaired intestinal mucosal barrier may be involved in the Gd-IgA1 expression,which could show promise in the diagnosis and treatment of IgAN.