血液及尿液中相关生物学标记物在蛋白尿性肾脏疾病中的变化及意义

    Changes and significance of blood/urine-related biomarkers in proteinuria induced kidney disease

    • 摘要: 目的 分析不同病理类型的蛋白尿性肾脏疾病患者血液、尿液中PLA2R、CD80、suPAR、Gd-IgA的水平,旨在为患者提供无创、适用广泛、精准的早期诊断方法。方法 收集东莞市滨海湾中心医院(原东莞市第五人民医院)于2019年6月1月至2020年3月31日住院或门诊治疗的蛋白尿性肾脏疾病患者及健康体检者的血、尿标本,并进行治疗前后的相关生物学标记物的检测,分析血、尿中相关生物学标记物在蛋白尿性肾脏疾病中的变化及意义。结果 尿液中CD80水平显著升高,而其余指标较其他蛋白尿性肾脏疾病(proteinuric kidney disease,PKD)升高水平不明显提示发生微小病变型肾病(minimal change disease,MCD)可能;血液中suPAR水平明显升高,且其他相关生物学标记物指标较正常对照升高显著的可能为局灶性节段性肾小球硬化(focal segmental glomurular sclerosis,FSGS)患者;膜性肾病(membranous nephropathy,MN)患者血液中PLA2R含量多居高不下,经治疗后该数值仍远远大于正常对照值;MPGN患者的多项生物学标记物指标多略高于正常对照值;IgAN患者血液中血Gd-IgA多明显升高,但血液中PLA2R尿液与CD80多为正常或低于正常对照值;在缺乏精准的治疗方案下,长期激素和(或)免疫抑制剂治疗也难以取得满意的疗效。结论 纳入研究的5种类型蛋白尿性肾脏疾病与健康体检人群的血、尿中相关生物学标记物存在不同程度的差异,对PKD患者的早期诊断有一定意义,未来可以通过进一步研究,为不同类型PKD患者提供早期针对性的治疗方案。

       

      Abstract: Objective Toexplore the levels of PLA2R,CD80,suPAR and Gd-IgA in blood and urine specimens of patients with different pathological types of proteinuria kidney disease (PKD) to offer a noninvasive,widely applicable and accurate early diagnostic method.Methods From June 1,2019 to March 31,2020,blood and urine specimens were collected from inpatients or outpatients with PKD and healthy subjects.The relevant biological markers were detected before and after treatment.The changes and significance of blood/urine-related biomarkers were analyzed.Results The urinary level of CD80 was significantly higher than that in other PKDs.It hinted at a possibility of minimal change disease (MCD);The blood level of suPAR was markedly elevated and other biological markers spiked significantly in focal segmental glomerular sclerosis (FSGS);The blood content of PLA2R was elevated in membranous nephropathy (MN) patients and remained much higher than normal control after treatment;Many biological markers in membrane proliferative glomerulonephritis (MPGN) patients were slightly higher than normal control values;The serum level of GD-IgA spiked markedly in IgAN patients.However,PLA2R in urine and CD80 in blood stayed basically normal or were lower than normal control values;Long-term hormone and/or immunosuppressive therapy could not achieve satisfactory outcomes without a precise treatment.Conclusion For five types of PKDs and healthy people,blood/urine-related biomarkers have varying degrees of difference so that accurate treatments may be tailored.

       

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