Abstract
Objective To investigate the relationship between serum B cell activating factor(BAFF),com-plement B factor(CFB),monocyte chemoattractant protein-1(MCP-1)and anti-M-type phospholipase A2 re-ceptor(PLA2R)antibodies in membranous nephropathy(MN)and their role in the evaluation of disease and efficacy.Methods A total of 108 patients with MN admitted to the hospital from January 2022 to June 2023 were selected as the research object.Patients were divided into remission group and non-remission group ac-cording to clinical efficacy.The levels of serum BAFF,CFB,MCP-1,and anti-PLA2R antibodies were com-pared between patients with positive and negative anti-PLA2R antibodies and different pathological stages.Clinical data of the remission group and the non-remission group were compared.The correlation between the levels of serum BAFF,CFB,and MCP-1 of patients with positive anti-PLA2R antibodies and the level of anti-PLA2R antibodies was analyzed by using pearson correlation analysis.Spearman correlation analysis was used to analyze the correlation between the levels of serum BAFF,CFB,and MCP-1 of MN patients and their patho-logical stages.Multivariate Logistic regression analysis was used to analyze the factors that affect the non-re-mission of MN patients after treatment.The predictive value of serum anti-PLA2R antibodies,BAFF,CFB,and MCP-1 for non-remission in MN patients after treatment was analyzed by using receiver operating charac-teristic(ROC)curve analysis.Results There were 78 patients with positive anti-PLA2R antibodies and 30 patients with negative anti-PLA2R antibodies.The levels of BAFF,CFB,MCP-1,and anti-PLA2R antibodies in the serum of patients with positive anti-PLA2R antibodies were higher than those in patients with negative anti-PLA2R antibodies,and the differences were statistically significant(P<0.05).The results of the com-parison of serum BAFF,CFB and MCP-1 levels in MN patients with different stages showed that stage Ⅰ<stage Ⅱ<stage Ⅲ<stage Ⅳ,and there were statistical significance between any pair comparison(P<0.05).Pearson correlation analysis showed that the levels of BAFF,CFB,and MCP-1 in the serum of patients with positive anti-PLA2R antibodies were positively correlated with the level of anti-PLA2R antibodies(r=0.792,0.823,0.832;P<0.001).Spearman correlation analysis showed that the levels of BAFF,CFB,and MCP-1 in the serum of patients with MN were positively correlated with pathological stage(rs=0.758,0.752,0.717,P<0.001).Thirty-three patients were included in the non-remission group,and 75 patients were included in the remission group,including 29 patients with complete remission and 46 patients with par-tial remission.The pathological stage,anti-PLA2R antibody,BAFF,CFB,and MCP-1 levels in the non-remis-sion group were higher than those in the remission group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that elevated serum BAFF,CFB and MCP-1 lev-els were risk factors for non-remission in MN patients after treatment(P<0.05).ROC curve analysis results showed that the area under the curve of the combined prediction of serum BAFF,CFB and MCP-1 for non-re-sponse after treatment in MN patients was 0.948,which was larger than that of the prediction of anti-PLA2R antibody and BAFF,CFB and MCP-1 alone(Z=4.116,3.059,4.122,4.116;P<0.05).Conclusion The lev-els of serum BAFF,CFB,and MCP-1 in patients with MN are related to the level of anti-PLA2R antibodies,the stage of MN,and the efficacy of treatment.The combined detection of serum BAFF,CFB,and MCP-1 has high predictive value for non-remission in patients with MN after treatment.关键词
B细胞活化因子/补体B因子/单核细胞趋化蛋白-1/膜性肾病/抗M型磷脂酶A2受体/相关性/病情/疗效Key words
B cell activating factor/complement B factor/monocyte chemotactic protein-1/membranous nephropathy/anti-M-type phospholipase A2 receptor/relevance/state of the disease/curative effect分类
临床医学
