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本研究通过纳入苏州大学附属苏州九院2021年3月-2024年3月期间收治的133例IgA肾病（Immunoglobulin A nephropathy,IgAN）患者的临床资料进行回顾性分析，其中合并乙型肝炎病毒（Hepatitis B virus,HBV）感染39例作为感染组，94例未感染者作为未感染组。另选取无肾脏疾病的单纯乙型肝炎病毒感染病患80例作为对照组。并采用实时荧光定量PCR技术检查感染组血清HBV-DNA载量，根据载量的不同将其分为高载量组（n=19）、中载量组（n=12）和低载量组（n=8），比较各组患者血清sCD89、C1GalT1水平差异，并通过spearman相关性分析法分析上述血清指标与HBV-DNA载量的相关性，应用受试者工作曲线分析其对IgAN伴HBV感染的诊断价值。结果显示，感染组血清sCD89水平高于未感染组和对照组，C1GalT1较对照组和未感染组偏低，且随着感染组患者HBVDNA载量的升高，血清sCD89呈升高趋势，血清C1GalT1呈降低趋势（均P<0.05）。血清sCD89、C1GalT1水平单独检测诊断IgA肾病HBV感染的AUC分别为0.737(0.623～0.871)、0.755(0.634～0.881)，两项指标联合检测后，其AUC提高至0.916(0.815～0.923)。相关性分析结果显示，血清sCD89水平与IgA肾病伴HBV感染患者HBVDNA载量呈正相关（r=0.604,P<0.05）；血清C1GalT1与HBV-DNA载量呈负相关（r=-0.711,P<0.05）。提示血清sCD89和C1GalT1水平变化与IgA肾病伴乙型肝炎病毒感染及HBV-DNA载量的增加相关，且两者联合检测具有更高的诊断效能。
Abstract：This study retrospectively analyzed the clinical data of 133 patients with Immunoglobulin A nephropathy(IgAN) treated in our hospital from March 2021 to March 2024. Among these, 39 patients with hepatitis B virus(HBV) infection were classified as the infected group, and 94 patients without HBV infection were classified as the uninfected group. Additionally, 80 patients with HBV infection but without renal disease were selected as the control group. Real-time fluorescence quantitative PCR was used to assess the HBV-DNA load in the infected group. Based on the HBV-DNA load, the infected group was further subdivided into highload group(n=19), medium-load group(n=12), and low-load group(n=8). Serum levels of sCD89 and C1GalT1 were compared across the groups, and the correlation between these serum markers and HBV-DNA load was analyzed using Spearman correlation analysis. Receiver operating characteristic(ROC) curve analysis was performed to evaluate the diagnostic value of sCD89 and C1GalT1 for HBV-infected IgAN. The results showed that the serum sCD89 levels were higher in the infected group than in the uninfected and control groups, while C1GalT1 levels were lower compared to the control and uninfected groups. Furthermore., as HBV-DNA load increased in the infected group, serum sCD89 levels showed an upward trend, while C1GalT1 levels showed a downward trend(both P<0.05). The area under the ROC curve(AUC) for serum sCD89 and C1GalT1 levels in diagnosing HBV-infected IgAN were 0.737(95% CI: 0.623-0.871) and 0.755(95% CI: 0.634-0.881), respectively. When combined, the AUC improved to 0.916(95% CI: 0.815-0.923). Correlation analysis revealed that serum sCD89 levels were positively correlated with HBV-DNA load in patients with HBV-infected IgAN(r=0.604, P<0.05), while serum C1GalT1 levels were negatively correlated with HBV-DNA load(r=-0.711, P<0.05). These findings suggest that changes in serum sCD89 and C1GalT1 levels are associated with HBV-infected IgAN and increasing HBV-DNA load. Moreover, the combined detection of these two markers offers higher diagnostic efficacy.
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基本信息:
DOI：10.13242/j.cnki.bingduxuebao.004617
中图分类号:R692.6
引用信息:
[1]刘蔚,华斐,凌凯等.血清sCD89、C1GalT1变化与HBV感染IgA肾病以及HBV-DNA载量的相关性研究[J].病毒学报,2024,40(06):1391-1396.DOI:10.13242/j.cnki.bingduxuebao.004617.
基金信息: