JASN:MBL对IgA肾病预后的预测价值

2017-11-10 MedSci MedSci原创

众所周知IgA肾病是我国最常见的血尿原因,其特点是感染伴随偶发肉眼血尿。而甘露糖结合凝集素(MBL)不足与许多疾病的反复感染有关,在其在IgA肾病中所扮演的角色还有所争议。近日在JASN上发表的一篇文章则探讨了MBL对于IgA肾病预后的预测价值。

众所周知IgA肾病是我国最常见的血尿原因,其特点是感染伴随偶发肉眼血尿。而甘露糖结合凝集素(MBL)不足与许多疾病的反复感染有关,在其在IgA肾病中所扮演的角色还有所争议。近日在JASN上发表的一篇文章则探讨了MBL对于IgA肾病预后的预测价值。

该研究测定了749例IgA肾病患者和489例健康对照者的MBL2变种和MBL的水平。研究结果显示总体而言,5.2%(39/749)的IgA患者存在MBL缺乏(MBL水平<100ng/ml),其中LYPB/LYPB和LXPA/LYPB是MBL2单倍体的主要形式(82%;32/39)。研究者还发现MBL水平与IgA肾病中肾脏的结局呈非线性关系。患有IgA肾病患者MBL水平缺乏相较于MBL水平正常(100-3540ng/ml)的人,更容易发生前驱感染和肉眼血尿。

除此之外,在多因素调整后发现MBL缺乏与IgA肾病中肾脏预后差独立相关(风险比,5.18;95%CI,2.5-10.72;p<0.001)。尽管在调整之后MBL高水平与IgA肾病进展并没有达到统计学意义,但MBL高水平(>3540 ng/ml)的患者蛋白尿更严重、新月体形成比例更高。

总之,MBL缺乏或过量都可能对 IgA肾病产生不良影响,这表明MBL可能通过多种机制作用于 IgA肾病发病。

原始出处:

Wei-yi Guo.et al. Mannose-Binding Lectin Levels Could Predict Prognosis in IgA Nephropathy.JASN.2017

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    2018-07-02 gdsun
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    2018-06-06 chenhongpeng
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    2017-11-12 yibei
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