[1]林远杰,吴淑芳,徐海山.IgA肾病患者尿可溶性CD163水平与治疗反应相关性分析[J].陕西医学杂志,2025,54(7):925-928,938.[doi:DOI:10.3969/j.issn.1000-7377.2025.07.010]
　LIN Yuanjie,WU Shufang,XU Haishan.Analysis of the correlation between urinary soluble CD163 levels and treatment response in patients with IgA nephropathy[J].,2025,54(7):925-928,938.[doi:DOI:10.3969/j.issn.1000-7377.2025.07.010]
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IgA肾病患者尿可溶性CD163水平与治疗反应相关性分析

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
54
期数:
2025年7期
页码:
925-928,938
栏目:
临床研究
出版日期:
2025-07-05

文章信息/Info

Title:
Analysis of the correlation between urinary soluble CD163 levels and treatment response in patients with IgA nephropathy
作者:
林远杰; 吴淑芳; 徐海山
（莆田学院附属医院肾内科，福建 莆田 351100）
Author(s):
LIN Yuanjie; WU Shufang; XU Haishan
（Department of Nephrology，Affiliated Hospital of Putian University，Putian 351100，China）
关键词:
尿可溶性CD163; IgA肾病; 24 h尿蛋白; 估算的肾小球滤过率; 预测模型; ROC曲线分析
Keywords:
Urinary soluble CD163; IgA nephropathy; 24-hour urinary protein quantification; Estimated glomerular filtration rate; Predictive model; ROC curve analysis
分类号:
R 692
DOI:
DOI:10.3969/j.issn.1000-7377.2025.07.010
文献标志码:
A
摘要:
目的：探究尿可溶性CD163（u-sCD163）水平对IgA肾病治疗反应的预测价值。方法： 选取IgA肾病患者120例，按照不同的治疗方法将患者分成常规治疗组、糖皮质激素治疗组、免疫抑制剂组三组，每组40例。收集患者年龄、性别、24 h尿蛋白、血肌酐和估算的肾小球滤过率（eGFR）水平，酶联免疫吸附测定（ELISA）测定u-sCD163水平。根据每组治疗结果，将患者分为治疗有效和治疗无效组。通过二元Logistic回归分析u-sCD163是否为治疗结局的危险因素，并通过受试者工作特征（ROC）曲线评估u-sCD163对治疗反应的预测价值。结果： 常规治疗组、糖皮质激素治疗和免疫抑制剂治疗的治疗总有效率分别为60.0%、72.5%和67.5%。三组患者治疗有效患者共80例，治疗无效共40例。治疗有效组和治疗无效组患者年龄、性别、身体重量指数（BMI）和肌酐等方面比较无统计学差异（均P＞0.05）。治疗有效组24 h尿蛋白和u-sCD163水平分别为（0.51±0.20）g和（3.91±1.81） ng/mg，显著低于治疗无效组24 h尿蛋白和u-sCD163水平（0.84±0.49）g和（7.50±1.73）ng/mg（均P＜0.05）；治疗有效组eGFR水平为（91.33±21.48）ml/（min·1.73 m2），显著高于治疗无效组eGFR水平（82.73±20.44）ml/（min·1.73 m2）（P＜0.05）。二元Logistic回归分析结果显示，24 h尿蛋白和u-sCD163水平是治疗有效性的影响因素（均P＜0.05），治疗有效率将随24 h尿蛋白和u-sCD163水平的降低而升高；eGFR也是治疗有效性的影响因素（P=0.041），治疗有效率随eGFR水平增加而增加。ROC分析显示，24 h尿蛋白联合eGFR为临床指标预测的曲线下面积为0.750，u-sCD163单独预测的曲线下面积为0.918，将24 h尿蛋白、eGFR联合u-sCD163的曲线下面积为0.934。结论： u-sCD163随治疗效果显现，水平显著降低。u-sCD163和24 h尿蛋白、eGFR联合显著提高了预测效能，可作为 IgA 肾病治疗的有效性预测标志物。
Abstract:
Objective: To investigate the predictive value of urinary soluble CD163(u-sCD163) level for treatment response in patients with IgA nephropathy.Methods：A total of 120 patients with IgA nephropathy were enrolled and divided into three groups according to treatment modality：conventional therapy group，glucocorticoid therapy group，and immunosuppressant therapy group，with 40 patients in each group.Patients’ age，gender，24 h urine protein，blood creatinine and estimated glomerular filtration rate(eGFR) levels were collected，and u-sCD163 levels were determined by enzyme-linked immunosorbent assay(ELISA).Patients were divided into treatment effective and treatment ineffective groups based on the outcome of each treatment group. Binary logistic regression analysis was performed to identify risk factors affecting treatment outcomes，and receiver operating characteristic(ROC) curve analysis was used to evaluate the predictive value of u-sCD163.Results: The overall treatment efficacy rates of the conventional treatment group，glucocorticoid treatment and immunosuppressant treatment were 60.0%，72.5% and 67.5%，respectively.There were 80 patients with effective treatment and 40 patients with ineffective treatment in the three groups.There was no statistically significant difference in age，gender，BMI and creatinine between the treatment effective group and the treatment ineffective group( all P＞0.05).The 24h urine protein and u-sCD163 levels in the treatment-effective group were( 0.51±0.20)g and(3.91±1.81 )ng/mg，respectively，which were significantly lower than those in the treatment-ineffective group，which were(0.84±0.49)g and(7.50±1.73)ng/mg(all P＜0.05).the eGFR level in the treatment-effective group was(91.33± 21.48)ml/（min·1.73 m2），which was significantly higher than the eGFR level of( 82.73±20.44)ml/（min·1.73 m2）in the treatment-ineffective group(P＜0.05).The results of binary logistic regression analysis showed that 24h urine protein and u-sCD163 levels were the influencing factors of treatment effectiveness(all P＜0.05)，and the treatment effectiveness would increase with the decrease of 24h urine protein and u-sCD163 levels；eGFR was also an influencing factor of treatment effectiveness(P=0.041)，and the treatment effectiveness increased with the increase of eGFR levels ROC analysis showed that the area under the curve predicted by 24 h urinary protein combined with eGFR as a clinical indicator was 0.750，the area under the curve predicted by u-sCD163 alone was 0.918，and the area under the curve combining 24 h urinary protein，and eGFR combined with u-sCD163 was 0.934.Conclusion:The levels of u-sCD163 decreased significantly with the effects of treatment.u-sCD163 in combination with 24 h urine protein and eGFR significantly improved the predictive efficacy and can be used as a predictive marker of the effectiveness of treatment for IgA nephropathy.

参考文献/References:

[1]李春梦, 屈凯, 王春柳,等.血清中IgA/C3检测在IgA肾病诊断中的意义[J].陕西医学杂志，2018，47(1)：123-125.
[2]周洋，李贵森，邹杨.钠-葡萄糖共转运体2抑制剂治疗难治性IgA肾病1例报告[J].中国实用内科杂志，2023，43(10)：877-880.
[3]刘兴红，戴欢子.IgA肾病精准治疗策略的探索[J].临床肾脏病杂志，2022，22(3)：253-258.
[4]王淑锦，姚婷婷，李璐，等.血清sCD163水平与慢性阻塞性肺疾病急性加重期患者炎症因子及气道重塑的关系[J].中国急救复苏与灾害医学杂志，2024，19(8)：1034-1037，1054.
[5]王小芳，张利军.可溶性人髓系细胞触发受体1、可溶性血红蛋白清道夫受体、降钙素原表达水平对肝硬化合并自发性细菌性腹膜炎的诊断价值[J].陕西医学杂志，2010，50(12)：1525-1527.
[6]YOKOE Y，TSUBOI N，IMAIZUMI T，et al.Clinical impact of urinary CD11b and CD163 on the renal outcomes of anti-neutrophil cytoplasmic antibody-associated glomerulonephritis[J].Nephrol Dial Transplant，2021，36(8)：1452-1463.
[7]GONG S，JIN S，LI Y，et al.Urinary soluble CD163 levels predict iga nephropathy remission status[J].Front Immunol，2021，12：769802.
[8]杨迷玲，徐宪伟，张果，等.尿可溶性CD163在慢性移植肾肾损伤中的作用[J].实用医学杂志，2018，34(22)：3731-3735.
[9]VILLACORTA J，LUCIENTES L，GOICOECHEA E，et al.Urinary soluble CD163 as a biomarker of disease activity and relapse in antineutrophil cytoplasm antibody-associated glomerulonephritis[J].Clin Kidney J，2021，14(1)：212-219.
[10]CATTRAN D C，FEEHALLY J，COOK H T，et al.Kidney disease：Improving global outcomes(KDIGO) glomerulonephritis work group.KDIGO clinical practice guideline for glomerulonephritis[J].Kidney International Supplements，2012，2(2)：139-274.
[11]OLIVERIO A L，PEAGLER A，MITCHELL R，et al.Design of a user-centered electronic health tool for glomerular disease management[J].Glomerular Dis，2024，4(1)：105-118.
[12]黄锦，李姗姗，杨锦惠，等.从陈香美院士团队诊治IgA肾病谈中西医整合[J].医学争鸣，2020，11(1)：29-32，36.
[13]MAGISTRONI R，D’AGATI V D，APPEL G B，et al.New developments in the genetics，pathogenesis，and therapy of IgA nephropathy[J].Kidney Int，2015，88(5)：974-989.
[14]LEE M，SUZUKI H，NIHEI Y，et al.Ethnicity and IgA nephropathy：Worldwide differences in epidemiology，timing of diagnosis，clinical manifestations，management and prognosis[J].Clinical Kidney Journal，2023，16(Supplement_2)：ii1-ii8.
[15]ZHANG H，BARRATT J.Is IgA nephropathy the same disease in different parts of the world?[C]//Seminars in immunopathology.berlin/heidelberg：Springer berlin heidelberg，2021，43(5)：707-715.
[16]ROBERT T，CAMBIER A，HERTIG A.Intensive supportive care plus immunosuppression in IgA nephropathy[J].N Engl J Med，2016，374(10)：991.
[17]张继超，张英才，刘静，等.血D-二聚体与24h尿蛋白在IgA肾病中的临床研究[J].中国临床医生杂志，2020，48(3)：288-290.
[18]王利元，刘红.益气活血化瘀方联合泼尼松治疗IgA肾病伴新月体形成患者肾功能及24h尿蛋白的影响[J].湖北中医杂志，2023，45(11)：16-18.
[19]杨志英，王晓丹，芮章茹，等.IgA肾病伴新月体形成合并肾衰竭的治疗方案比较及肾组织TWEAK的表达差异[J].中国中西医结合肾病杂志，2024，25(8)：683-687，756.
[20]REZAEE M，FOROUTAN F，ETEMAD L，et al.Clinical Utility of Soluble CD163 and its diagnostic and prognostic value in a variety of neurological disorders[J].Mini Rev Med Chem，2023，23(16)：1592-1607.
[21]IKEZUMI Y，SUZUKI T，KARASAWA T，et al.Identification of alternatively activated macrophages in new-onset paediatric and adult immunoglobulin A nephropathy：Potential role in mesangial matrix expansion[J].Histopathology，2011，58(2)：198-210.
[22]CORTINOVIS M，PERICO N，RUGGENENTI P，et al.Glomerular hyperfiltration[J].Nature reviews Nephrology，2022，18(7)：435-451.
[23]EBERT N，BEVC S，BKENKAMP A，et al. Assessment of kidney function：Clinical indications for measured GFR[J].Clinical Kidney Journal，2021，14(8)：1861-1870.
[24]胡海燕，韦懿，胡勤.尿可溶性CD163水平对儿童原发性肾病综合征激素治疗反应的预测价值[J].长春中医药大学学报，2022，38(4)：435-438.

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备注/Memo

备注/Memo:
福建省中青年教师教育科研项目（科技类）（JAT220291）
更新日期/Last Update: 2025-07-07