转化生长因子-β水平与激素耐药型肾病综合征患者环磷酰胺治疗反应性的相关性

Correlation between transforming growth factor-β levels and responsiveness to cyclophosphamide therapy in patients with hormone-resistant nephrotic syndrome

目的探讨转化生长因子-β(transforming growth factor-β,TGF-β)水平与激素耐药型肾病综合征(steroid-resistant nephrotic syndrome,SRNS)患者环磷酰胺治疗反应性的相关性。方法选择2019年1月至2020年10月金华文荣医院145例SRNS患者,入院后所有患者均接受TGF-β检测及环磷酰胺冲击治疗,治疗后根据患者环磷酰胺治疗反应性将患者分为高反应组和低反应组,采用Pearson相关系数分析TGF-β水平与SRNS患者环磷酰胺治疗反应性的相关性,采用二元Logistic回归分析探讨SRNS患者环磷酰胺治疗反应不佳的影响因素。结果145例SRNS患者中共139例完成环磷酰胺冲击治疗,其中80例患者对环磷酰胺治疗反应性高为高反应组,59例为低反应组;Pearson相关系数分析显示,TGF-β水平与SRNS患者环磷酰胺治疗反应性呈负相关(P<0.05);二元Logistic回归分析结果显示高TGF-β(OR=1.480)、24h定量尿蛋白(OR=1.818)是SRNS患者环磷酰胺治疗反应不佳的危险因素(P<0.05),高白蛋白(OR=0.859)是SRNS患者环磷酰胺治疗反应不佳的保护因素(P<0.05)。结论TGF-β水平与SRNS患者环磷酰胺治疗反应性呈负相关性,且TGF-β、白蛋白、24h定量尿蛋白均与SRNS患者环磷酰胺治疗反应性具有相关性。

Objective To investigate the correlation between the level of transforming growth factor-β(TGF-β)and the response to cyclophosphamide treatment in patients with steroid-resistant nephrotic syndrome(SRNS).Methods A total of 145 patients with SRNS in inhua Wenrong Hospital from January 2019 to October 2020 were included.After admission,all patients received TGF-βmeasurement and cyclophosphamide pulse therapy.After treatment,the patients were divided into high-response group and low-response group according to the response to cyclophosphamide treatment.Pearson correlation coefficient was used to analyze the correlation between TGF-βlevels and cyclophosphamide treatment response in patients with SRNS in high response group and low response group.Binary Logistic regression analysis was used to explore the influencing factors of poor response to cyclophosphamide treatment in SRNS patients.Results A total of 139 of 145 SRNS patients completed pulse cyclophosphamide treatment.Among them,80 patients with high response to cyclophosphamide treatment were in the high-response group,and 59 patients were in the low-response group;Pearson correlation coefficient analysis showed that the level of TGF-βwas negatively correlated with cyclophosphamide treatment response in SRNS patients(P<0.05).Binary Logistic regression analysis showed that high TGF-β(OR=1.480)and 24h quantitative urinary protein(OR=1.818)were the main factors for cyclophosphamide in SRNS patients.Risk factors for poor response to treatment(P<0.05),high albumin(OR=0.859)was a protective factor for poor response to cyclophosphamide in SRNS patients(P<0.05).Conclusion The level of TGF-βis negatively correlated with the response to cyclophosphamide treatment in SRNS patients,and TGF-β,albumin and 24h quantitative urinary protein are all correlated with the response to cyclophosphamide treatment in SRNS patients.