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目的 探讨尿液C-C基序趋化因子配体2（CCL2）、基质金属蛋白酶7（MMP7）水平与IgA肾病患者预后的关系。方法 纳入125例IgA肾病患者，收集其基线资料，并检测其尿液CCL2、MMP7水平。随访2年，根据预后将患者分为预后良好组、预后不良组，比较两组上述指标。采用多因素Logistic回归模型分析IgA肾病患者预后的影响因素。采用受试者工作特征（ROC）曲线分析尿液CCL2、MMP7水平对IgA肾病患者预后的预测价值。结果 有5例患者失访，最终纳入120例患者。随访期间，21例患者出现预后不良（预后不良组）、99例患者未出现预后不良（预后良好组）。两组血红蛋白水平、血清白蛋白水平、血钙水平、血清肌酐水平、估算肾小球滤过率（eGFR）、24 h尿蛋白定量水平比较，差异有统计学意义（P＜0.05），且预后不良组尿液CCL2、MMP7水平高于预后良好组（P＜0.05）。多因素Logistic回归分析结果显示，eGFR、24 h尿蛋白定量水平、尿液CCL2和MMP7水平是IgA肾病患者预后的影响因素（P＜0.05）。尿液CCL2、MMP7水平单独及联合预测IgA肾病患者预后不良的曲线下面积分别为0.804、0.914、0.950。结论 尿液CCL2、MMP7水平是IgA肾病患者预后的影响因素，二者均对IgA肾病患者预后不良具有一定预测价值，且联合预测的价值相对更高。
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论著·临床研究
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更新时间：2023-12-05
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尿液CCL2、MMP7水平与IgA肾病患者预后的关系
Relation of urine CCL2 and MMP7 levels with prognosis of patients with IgA nephropathy
广西医学 2023第45卷18期 页码：2180-2183+2190
作者机构：许雅楠，硕士，住院医师，研究方向：IgA肾病。
基金信息：山西省卫生健康委员会科研课题（2022038）
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- 英文简介
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ObjectiveTo investigate the relation of urine C-C motif chemokine ligand 2 (CCL2) and matrix metalloproteinase 7 (MMP7) levels with prognosis of patients with IgA nephropathy. MethodsA total of 125 patients with IgA nephropathy were enrolled, their baseline data were collected, and their urine CCL2 and MMP7 levels were detected. Patients were assigned to favorable prognosis group or adverse prognosis group according to prognosis after 2-year follow-up, and the aforementioned indices were compared between the two groups. The multivariate Logistic regression model was used to analyze the influencing factors for prognosis of patients with IgA nephropathy. The predictive value of urine CCL2 and MMP7 levels for prognosis of patients with IgA nephropathy was analyzed by employing the receiver operating characteristic (ROC) curve. ResultsFive patients were lost to follow-up, and 120 patients were eventually enrolled. During follow-up, 21 patients suffered from adverse prognosis (the adverse prognosis group), and 99 patients did not suffer from adverse prognosis (the favorable prognosis group). There were statistically significant differences in the levels of hemoglobin, serum albumin, blood calcium, serum creatinine, and estimated glomerular filtration rate (eGFR), as well as 24-hour urinary protein quantity level between the two groups (P＜0.05); furthermore, the adverse prognosis group exhibited higher levels of urine CCL2 and MMP7 as compared with the favorable prognosis group (P＜0.05). The results of multivariate Logistic regression analysis revealed that eGFR, 24-hour urinary protein quantity level, urine CCL2 and MMP7 levels were the influencing factors for prognosis of patients with IgA nephropathy (P＜0.05). Areas under the curve of urine CCL2 and MMP7 levels for alone and jointly predicting adverse prognosis of patients with IgA nephropathy were 0.804, 0.914, and 0.950, respectively. ConclusionUrine CCL2 and MMP7 levels are influencing factors for prognosis of patients with IgA nephropathy, both of which exert predictive value for adverse prognosis of patients with IgA nephropathy to a certain extent, and the combination exerts a relatively higher predictive value.
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