發(fā)布時(shí)間：2019-02-09 11:34

【摘要】：目的探討腫瘤壞死因子α(tumor necrosis factor-α,TNF-α)在抗中性粒細(xì)胞胞漿抗體相關(guān)性血管炎(ANCAassociated vasculitis,AAV)中對(duì)腎臟損害程度及預(yù)后意義。方法回顧性分析我院2013年7月至2017年7月腎內(nèi)科經(jīng)病理活檢確診的41例AAV腎損害患者的臨床資料。采用放射免疫法檢測血清TNF-α水平。隨訪腎臟結(jié)局利用ROC曲線取TNF-α截點(diǎn)(Cut off值)為14.1 pg/ml,將總體AAV腎損害患者分為高水平TNF-α(≥14.1 pg/ml)及低水平TNF-α(14.1 pg/ml)組,并比較2組患者生物學(xué)特征、腎臟病理特征及預(yù)后。結(jié)果高水平TNF-α組與低水平組相比,伯明翰血管炎活動(dòng)性評(píng)分(Birmingham vasculitis activity score,BVAS)及肌酐(serum creatinine,Scr)、IL-6、IL-8水平顯著升高(P0.05),腎小球?yàn)V過率(estimated glomerular filtration rate,e GFR)、補(bǔ)體3(complement 3,C3)顯著下降(P0.05)。TNF-α與ALB、eGFR、Cys-c、BVAS、ESR、IL-6具有相關(guān)性,相關(guān)系數(shù)r分別為-0.37、-0.49、0.55、0.50、0.32、0.34(P0.05)。腎臟病理特征顯示TNF-α水平升高組腎間質(zhì)纖維化及腎小管萎縮程度更重(P0.05)。Kaplan-Meier生存分析顯示TNF-α水平升高組腎臟存活率低(Log-Rank=5.230,P=0.022)。結(jié)論血清TNF-α水平升高是反映腎臟損傷程度及預(yù)后的危險(xiǎn)因素。
[Abstract]:Objective to investigate the significance of tumor necrosis factor 偽 (tumor necrosis factor- 偽 (TNF- 偽) in renal damage and prognosis in patients with anti-neutrophil cytoplasmic antibody associated vasculitis (ANCAassociated vasculitis,AAV). Methods the clinical data of 41 patients with AAV renal lesion confirmed by pathological biopsy from July 2013 to July 2017 in our hospital were retrospectively analyzed. Serum TNF- 偽 levels were measured by radioimmunoassay. The renal outcome was followed up by ROC curve. The (Cut off value of TNF- 偽 was 14. 1 pg/ml,. The patients with total AAV renal damage were divided into high TNF- 偽 (鈮，

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