血清补体H因子及血管生成抑制蛋白-1与狼疮肾炎患者肾损伤进展的关系

The relationship between serum complement H factor,VASH-1 and the progression of renal injury in LN patients

目的探讨血清补体H因子(CFH)及血管生成抑制蛋白-1(VASH-1)与狼疮肾炎(LN)患者肾损伤进展的关系.方法回顾性分析本院2019年12月至2020年12月收治的112例LN患者的临床病例资料.按照国际肾脏病协会和肾脏病理学会(ISN/RPS)评分将患者分为Ⅰ级29例、Ⅱ级36例、Ⅲ级30例、≥Ⅳ级17例.另选取同期本院的健康体检者30例患者作为对照组.比较各组患者的血清CFH、VASH-1水平,比较各组的24 h尿蛋白排泄率(UAER)、尿微量白蛋白(mALB)及血肌酐(Scr)水平.采用Pearson相关性分析血清CFH、VASH-1水平与肾功能生化指标的关系,采用Spearman相关性分析血清CFH、VASH-1水平与肾功能损伤的关系.结果对照组、Ⅰ级、Ⅱ级、Ⅲ级和≥Ⅳ级患者的血清CFH水平逐渐降低,组间差异均有统计学意义(均P<0.001),血清VASH-1水平逐渐升高,组间差异均有统计学意义(均P<0.001);对照组、Ⅰ级、Ⅱ级、Ⅲ级和≥Ⅳ级患者的Scr、尿mALB、UAER水平逐渐升高,组间差异均有统计学意义(均P<0.001);相关性分析结果显示:血清CFH水平与肾损伤程度、Scr、尿mALB、UAER水平均呈负相关(均P<0.001),血清VASH-1水平与肾损伤程度、Scr、尿mALB、UAER水平均呈正相关(均P<0.001).结论血清CFH、VASH-1水平与LN患者肾损伤具有显著相关性,可作为临床辅助性评估LN患者肾损伤程度的参考指标.

Objective To explore the relationship between serum complement H(CFH)and angiogenesis inhibitor protein-1(VASH-1)and the progression of renal injury in patients with lupus research object nephritis(LN).Methods A retrospective analysis of 112 clinical case data of LN patients admitted to our hospital from December 2019 to December 2020.According to the ISN/RPS score,29 patients were classified as grade Ⅰ,36 as grade Ⅱ,30 as grade Ⅲ,and 17 as grade ≥ Ⅳ.In addition,30 healthy patients from our hospital who participated examination were selected as the control group.Serum CFH and VASH-1 levels,24 h urinary protein excretion rate(UAER),urinary microalbumin(mALB)and serum creatinine(Scr)levels were compared among all groups.The relationship between serum CFH and VASH-1 levels and renal function biochemical indexes was analyzed by Pearson correlation,and the relationship between serum CFH and VASH-1 levels and renal function injury was analyzed by Spearman correlation.Results The serum CFH level in control group,grade Ⅰ,Ⅱ,Ⅲ and≥ Ⅳ patients gradually decreased,and the differences were statistically significant(all P<0.001),while the serum VASH-1 level gradually increased,and the differences were statistically significant(all P<0.001).The levels of Scr,urinary mALB and UAER in control group,grade Ⅰ,Ⅱ,Ⅲ and≥Ⅳ patients increased gradually,and the differences were statistically significant(all P<0.001).Correlation analysis results show that:Serum CFH level was negatively correlated with the degree of kidney injury,Scr,urinary mALB and UAER levels(all P<0.001).Serum VASH-1 level was positively correlated with the degree of kidney injury,Scr,urinary mALB and UAER levels(all P<0.001).Conclusions Serum CFH and VASH-1 levels are significantly correlated with renal injury in LN patients,and can be used as a clinical auxiliary evaluation index for the degree of renal injury in LN patients.