PM2.5成分与特发性膜性肾病相关性研究

Study of the correlation between PM2.5 constituent chrysene and idiopathic membranous nephropathy

目的探索PM2.5主要成分多环芳烃(PAH)中的单体成分(chrysene,Chry)与特发性膜性肾病的相关性。方法收集郑州大学第一附属医院肾内科2020年6月至9月经皮肾穿刺活检明确诊断为特发性膜性肾病(IMN)的30例患者作为研究对象,其中男性20例(66.7%),女性10例(33.3%),年龄47.0(39.0,53.5)岁。留取全血标本采用高效液相法测定多环芳烃(PAH)单体成分浓度。分析血浓度与IMN患者血清白蛋白、24 h尿蛋白定量及血清抗磷脂酶A2受体(PLA2R)抗体等临床指标的相关性。结果IMN患者全血浓度0.035(0.024,0.086)mg/L;血浓度与24 h尿总蛋白(r=0.530,P=0.003)、胱抑素C(r=0.742,P<0.001)、β2微球蛋白(r=0.792,P<0.001)、PLA2R抗体(r=0.463,P=0.005)呈正相关,与血清白蛋白(r=-0.327,P=0.039)、血清IgG(r=-0.440,P=0.007)呈负相关,浓度每增加0.1 mg/L,PLA2R抗体浓度增加80.84 RU/mL(P<0.001)。结论多环芳烃成分参与特发性膜性肾病的发生发展。

Objective To explore the correlation between chrysene,a monomer component of polycyclic aromatic hydrocarbon(PAH),which is the main constituent in PM2.5,and idiopathic membranous nephropathy(IMN).Methods30 patients with IMN who were diagnosed by percutaneous needle biopsy in the department of nephrology of the First Affiliated Hospital of Zhengzhou University from June 2020 to September 2020 were selected as the research objects,including 20 males(66.7%)and 10 females(33.3%),aged 47.0(39.0,53.5)years.The whole blood concentration of PAH monomer component chrysene was measured by high performance liquid chromatography(HPLC).Analyze the relationship between chrysene and clinical indicators including serum albumin,24 h urinary protein quantitation,anti-PLA2R antibody,et al.Results The concentration of chrysene was 0.035(0.024,0.086)mg/L.Blood concentration of chrysene was positively correlated with 24 h urinary total protein(r=0.530,P=0.003),cystatin-C(r=0.742,P<0.001),β2microglobulin(r=0.792,P<0.001),anti-PLA2R antibody(r=0.463,P=0.005),and negatively correlated with serum albumin(r=-0.327,P=0.039)and serum IgG(r=-0.440,P=0.007).Every time the concentration of chrysene increased by0.1 mg/L,the concentration of anti-PLA2R antibody increased by 80.84 RU/mL(P<0.001).Conclusion PAH component chrysene participates in the occurrence and development of IMN.