实用医学杂志2025，Vol.41Issue(8)：1199-1204,6.DOI:10.3969/j.issn.1006-5725.2025.08.016
血清APRIL、PLA2R-Ab及25-(OH)D3水平与原发性膜性肾病病情和预后的关系
Study on the correlation between serum APRIL,PLA2R-Ab,and 25-(OH)D3 levels and the severity and prognosis of primary membranous nephropathy
摘要
Abstract
Objective Investigating the correlation between fluctuations in proliferation-inducing ligand(APRIL),M-type phospholipase A2 receptor antibody(PLA2R Ab),and 25-hydroxyvitamin D3[25-(OH)D3]levels and their impact on the severity and prognosis of primary membranous nephropathy(PMN).Methods A prospective study design was employed,wherein 100 confirmed PMN patients from Xingtai People's Hospital were recruited as the PMN group,and 100 healthy volunteers served as the control group.The levels of APRIL,PLA2R Ab,and 25-(OH)D3 were compared between the two groups of participants,stratified by PMN disease stage and treatment outcomes.A simple linear correlation analysis was conducted to evaluate the correlation between APRIL,PLA2R Ab,and 25-(OH)D3 with renal function indicators.Additionally,a multiple regression model was utilized to analyze the associations between these indicators and patient treatment outcomes as well as prognosis.Results The levels of APRIL and PLA2R Ab in the MN group were significantly higher than those in the control group,whereas the levels of 25-(OH)D3 were significantly lower than those in the control group(P<0.05).Among 100 patients with PMN,there were 20 in stage I,42 in stage Ⅱ,34 in stage Ⅲ,and 4 in stage Ⅳ.The levels of APRIL and PLA2R Ab in stage Ⅲ+Ⅳ patients were significantly higher than those in stage Ⅰ+Ⅱ patients,while the level of 25-(OH)D3 was significantly lower in stage Ⅲ+Ⅳ patients compared to stage Ⅰ+Ⅱ patients(P<0.05).In PMN patients,serum APRIL and PLA2R-Ab levels were negatively correlated with urea nitrogen(BUN),creatinine(Scr),and 24-h urinary protein(P<0.05).Additionally,APRIL and PLA2R-Ab levels were positively correlated with total protein(TP)and albumin(ALB)(P<0.05),while serum 25-(OH)D3 levels were negatively correlated with BUN,Scr,and 24-h urinary protein(P<0.05).After treatment,42 patients achieved complete remission,while 58 patients did not meet the remission criteria.Serum APRIL and PLA2R-Ab levels in the remis-sion group were significantly lower than those in the non-remission group both before treatment and after 12 months of treatment.Furthermore,serum 25-(OH)D3 levels in the remission group were significantly higher than those in the non-remission group both before treatment and after 12 months of treatment(P<0.05).Conclusions Elevated levels of serum APRIL and PLA2R antibodies,which contribute to immune dysfunction,are closely asso-ciated with the onset and severity of PMN.Renal impairment leads to a substantial reduction in serum 25-(OH)D3 levels.Collectively,these three indicators serve as critical markers for the occurrence,progression,and prognosis of PMN.关键词
增殖诱导配体/M型磷脂酶A2受体抗体/25-羟维生素D3/原发性膜性肾病/预后Key words
proliferation inducing ligand/M-type phospholipase A2 receptor antibody/25 hydroxyvi-tamin D3/primary membranous nephropathy/prognosis分类
医药卫生引用本文复制引用
郭音,任海青,郭晓阳,左江华,王婷..血清APRIL、PLA2R-Ab及25-(OH)D3水平与原发性膜性肾病病情和预后的关系[J].实用医学杂志,2025,41(8):1199-1204,6.基金项目
河北省卫生健康委科研基金项目(编号:20211222) （编号:20211222）
邢台市重点研发计划自筹项目(编号:2023ZC053) （编号:2023ZC053）
