Tim-3及其配体CEACAM1与特发性膜性肾病患者肾功能进展的相关性研究

Correlation association of Tim-3 and its ligand CEACAM1 with progression of renal function in patients with idiopathic membranous nephropathy

目的探讨特发性膜性肾病(IMN)患者血清T细胞免疫球蛋白黏蛋白分子-3(Tim-3)及其配体癌胚抗原相关细胞黏附分子1(CEACAM1)与其肾功能进展的相关性。方法选取2019年7月至2022年8月于该院住院并经肾组织活检确诊为IMN的80例患者作为IMN组,另选取77例同期体检健康者作为对照组。根据估算肾小球滤过率(eGFR)水平将IMN组分为肾功能正常组[eGFR>90 mL/(min·1.73 m^(2))],肾功能下降组[eGFR≤90 mL/(min·1.73 m^(2))]。采用酶联免疫吸附试验比较各组血清Tim-3、CEACAM1水平,分析IMN患者血清Tim-3、CEACAM1水平与一般临床指标的相关性,采用多因素Logistic回归分析影响IMN患者肾功能下降的危险因素。结果与对照组比较,IMN组血清Tim-3、CEACAM1水平升高(P<0.05);肾功能下降组血清Tim-3水平高于肾功能正常组(P<0.05);血清Tim-3水平与白蛋白、总蛋白、eGFR呈负相关(r=-0.266、-0.229、-0.374,P<0.05),与肌酐呈正相关(r=0.289,P<0.05);多因素Logistic回归分析结果显示,Tim-3水平升高是影响IMN患者肾功能下降的独立危险因素。结论IMN患者血清Tim-3、CEACAM1水平升高,Tim-3/CEACAM1可能在IMN的发生发展中发挥重要作用,血清Tim-3水平可为IMN患者治疗及预后提供一定依据。

Objective To investigate the correlation of serum T cell immunoglobulin mucin molecule-3(Tim-3)and its ligand carcinoembryonic antigen-related cell adhesion molecule-1(CEACAM1)with the progression of renal function in patients with idiopathic membranous nephropathy(IMN).Methods A total of 80 patients with IMN diagnosed by renal biopsy in this hospital from July 2019 to August 2022 were selected as the IMN group,and 77 healthy people in the same period were selected as the control group.IMN patients were divided into normal renal function group[eGFR>90 mL/(min·1.73 m^(2))]and decreased renal function group[eGFR≤90 mL/(min·1.73m^(2))]according to the level of estimated glomerular filtration rate(eGFR).Serum Tim-3 and CEACAM1 levels in each group were compared by enzyme-linked immunosorbent assay,and the correlation between serum Tim-3,CEACAM1 levels and general clinical indicators in IMN patients was analyzed.Multivariate Logistic regression analysis was used to analyze the risk factors of renal function decline in patients with IMN.Results Compared with the control group,the serum levels of Tim-3 and CEACAM1 were increased in the IMN group(P<0.05).The decreased renal function group had a significantly higher serum level of Tim-3 than the normal renal function group(P<0.05).Serum Tim-3 level was negatively correlated with albumin,total protein and eGFR(r=-0.266,-0.229,-0.374,P<0.05),and positively correlated with creatinine(r=0.289,P<0.05).Multivariate Logistic regression analysis showed that Tim-3 was an independent risk factor for renal function decline in patients with IMN.Conclusion Serum Tim-3 and CEACAM1 levels are increased in IMN patients.Tim-3/CEACAM1 may play an important role in the occurrence and development of IMN.Serum Tim-3 level can provide some basis for the treatment and prognosis of IMN patients.