李春, 操轩. 血清肾损伤分子-1在预测系统性红斑狼疮病人发生狼疮性肾炎中的临床价值研究[J]. 蚌埠医学院学报, 2022, 47(2): 188-191. DOI: 10.13898/j.cnki.issn.1000-2200.2022.02.012
    引用本文: 李春, 操轩. 血清肾损伤分子-1在预测系统性红斑狼疮病人发生狼疮性肾炎中的临床价值研究[J]. 蚌埠医学院学报, 2022, 47(2): 188-191. DOI: 10.13898/j.cnki.issn.1000-2200.2022.02.012
    LI Chun, CAO Xuan. Clinical value of serum kidney injury molecule-1 in the prediction of lupus nephritis in patients with systemic lupus erythematosus[J]. Journal of Bengbu Medical College, 2022, 47(2): 188-191. DOI: 10.13898/j.cnki.issn.1000-2200.2022.02.012
    Citation: LI Chun, CAO Xuan. Clinical value of serum kidney injury molecule-1 in the prediction of lupus nephritis in patients with systemic lupus erythematosus[J]. Journal of Bengbu Medical College, 2022, 47(2): 188-191. DOI: 10.13898/j.cnki.issn.1000-2200.2022.02.012

    血清肾损伤分子-1在预测系统性红斑狼疮病人发生狼疮性肾炎中的临床价值研究

    Clinical value of serum kidney injury molecule-1 in the prediction of lupus nephritis in patients with systemic lupus erythematosus

    • 摘要:
      目的探讨血清肾损伤分子-1(KIM-1)预测系统性红斑狼疮(SLE)病人发生狼疮性肾炎(LN)的临床价值。
      方法选择78例SLE病人为研究对象。所有SLE病人均获得有效随访,中位随访时间为5.9年(1~9.5年)。采用酶联免疫吸附实验检测基线时血清KIM-1水平。绘制ROC曲线分析KIM-1预测LN的价值,计算ROC曲线下面积(AUC)、95%CI、灵敏度和特异度;Kaplan-Meier法绘制不同KIM-1表达水平SLE病人发生LN的生存曲线,并用log-rank检验进行比较;采用Cox回归分析确定LN发生的因素。
      结果随访期间38例病人发生LN,占48.72%。LN组病人血清KIM-1浓度为(46.02±6.28)ng/L,高于非LN组病人的(23.56±5.29)ng/L,差异有统计学意义(t=22.40,P < 0.01)。以42.35 ng/L为截断值,KIM-1预测SLE病人发生LN的效果较好(AUC为0.715,95%CI:0.589~0.841;灵敏度和特异度分别为82.01%、56.33%)。高KIM-1组发生LN 37例,占71.15%;低KIM-1组发生LN 8例,占30.77%。高KIM-1组从SLE诊断到发生LN的中位时间为6.7年(4.8~8.5年),短于低KIM-1组的8.8年(7.7~9.7年),差异有统计学意义(P < 0.05)。KIM-1是LN发生的独立影响因素(HR=2.301,95%CI:1.235~3.964,P < 0.01)。
      结论SLE并发LN病人的血清KIM-1水平显著升高。血清KIM-1可能成为预测LN的有效生物标志物。

       

      Abstract:
      ObjectiveTo explore the clinical value of serum kidney injury molecule-1(KIM-1) in the prediction of lupus nephritis(LN) in patients with systemic lupus erythematosus(SLE).
      MethodsA total of 78 SLE patients were selected.The median follow-up time was 5.9 years(1-9.5 years).Enzyme-linked immunosorbent assay was used to detect the levels of serum KIM-1 at baseline.ROC curve was drawn to analyze the value of KIM-1 in predicting LN, calculate AUC, 95% confidence interval(CI), sensitivity and specificity under ROC curve.Kaplan-Meier method was used to draw survival curve of SLE patients with different KIM-1 expression levels, and compare with log-Rank test; Cox regression analysis was used to determine the factors of LN.
      ResultsDuring the follow-up period, LN occurred in 38 patients(48.72%).The serum KIM-1 concentration in LN group was(46.02±6.28) ng/L, which was significantly higher than that in non-LN group(23.56±5.29) ng/L(P < 0.01).With 42.35 ng/L as the cutoff value, KIM-1 had a better effect on predicting LN in SLE patients(AUC: 0.715, 95%CI: 0.589-0.841;sensitivity and specificity 82.01% and 56.33%, respectively).LN occurred in 37 cases(71.15%) in high KIM-1 group.LN occurred in 8 cases(30.77%) in low KIM-1 group.The median time from SLE diagnosis to LN in high KIM-1 group was 6.7 years(4.8-8.5 years), significantly shorter than that in low KIM-1 groupmedian time was 8.8 years(7.7-9.7 years)(P < 0.05).KIM-1 is an independent influencing factor of LN(HR=2.301, 95%CI: 1.235-3.964, P < 0.01).
      ConclusionsThe level of serum KIM-1 was significantly increased in patients with SLE complicated with LN, which may be an effective biomarker for the prediction of LN.

       

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