基础医学与临床2026，Vol.46Issue(1)：22-27,6.DOI:10.16352/j.issn.1001-6325.2026.01.0022
IgA肾病患者血清CHI3L1和sFlt-1水平与病情严重程度及预后相关
Level of serum CHI3L1 and sFlt-1 is correlated with disease severity and prognosis of patients with IgA nephropathy
摘要
Abstract
Objective To investigate the relationship of the serum chitinase-3-like protein 1(CHI3L1)and soluble fms-like tyrosine kinase-1(sFlt-1)with the severity and prognosis of IgA nephropathy patients.Methods One hun-dred and twenty-four patients with IgA nephropathy in Third Hospital of Peking University from September 2022 to August 2024.The cases were divided into mild,moderate and severe groups according to the severity of the disease.The prognosis was classified as good and poor prognosis groups;Serum CHI3L1 and sFlt-1 were measured by ELISA.The influencing factors of poor prognosis in IgA nephropathy patients were analyzed using logistic regres-sion.ROC curve was plotted to analyze the diagnostic value of serum CHI3L1 and sFlt-1 in patients with severe IgA nephropathy and their predictive value for poor prognosis in IgA nephropathy patients.Results The level of serum CHI3L1,sFlt-1,Scr,BUN,24-hour urinary protein and UA in the moderate and severe groups was found to be significantly higher than that in the mild group(P＜0.05),while Hb,Alb,and eGFR were prominently lower than those in the mild group(P＜0.05).Additionally,the level of CHI3L1,sFlt-1,Scr,BUN,24-hour urinary pro-tein and UA in the severe group were significantly higher than those in the moderate group(P＜0.05),Hb,Alb,and eGFR were obviously lower than those in the moderate group(P＜0.05).According to the ROC curve,the AUC of serum CHI3L1 and sFlt-1 in the diagnosis of severe IgA nephropathy patients was 0.833 and 0.865 re-spectively.The AUC of the combination of the two in the diagnosis of severe IgA nephropathy patients was 0.970,and the combination of the two was better than alone in diagnosis(Z=2.712,Z=2.725,both P＜0.05).Scr,BUN,24 h urine protein quantification and UA were significantly higher in the poor prognosis group than those in the good prognosis group(P＜0.05)and Hb,Alb and eGFR were significantly lower than in the good prognosis group(P＜0.05).Compared with the good prognosis group,the level of serum CHI3L1 and sFlt-1 were promi-nently higher in the poor prognosis group(P＜0.05).Multivariate logistic regression analysis revealed that CHI3L1,sFlt-1,Scr and 24-hour urinary protein quantification were risk factors predicting poor prognosis(P＜0.05)while eGFR was a protective factor(P＜0.05).According to the ROC curve,the AUC of serum CHI3L1 and sFlt-1 in predicting poor prognosis in IgA nephropathy patients was 0.820 and 0.771,respectively.The AUC of the combination of the two in predicting poor prognosis in IgA nephropathy patients was 0.879,and the combination of the two was better than single prediction(Z=2.692,Z=2.699,both P＜0.05).Conclusions The expression level of serum CHI3L1 and sFlt-1 is significantly elevated in patients with IgA nephropathy,and related to the severity and prognosis of the disease.Combined detection has certain clinical value in predicting the prognosis of patients.关键词
IgA肾病/壳多糖酶3样蛋白1/可溶性血管内皮生长因子受体-1/病情严重程度/预后Key words
IgA nephropathy/chitinase-3-like protein 1/soluble Fms-like tyrosine kinase-1/severity of disease/prognosis分类
医药卫生引用本文复制引用
孙迎春,李建军,杨再波,闫俊慧,刘育硕..IgA肾病患者血清CHI3L1和sFlt-1水平与病情严重程度及预后相关[J].基础医学与临床,2026,46(1):22-27,6.基金项目
秦皇岛市重点研发计划科技支撑项目(202101A035) （202101A035）
