系统性红斑狼疮肾炎患者尿podocalyxin和Nephrin水平与肾损伤相关性分析

目的 探讨系统性红斑狼疮肾炎患者尿podocalyxin和Nephrin水平与肾损伤的相关性。 方法 选取2017年6月—2018年6月期间绍兴市人民医院收治的80例系统性红斑狼疮肾炎患者作为研究对象(LN组)，选取同期绍兴市人民医院体检的80例健康人群作为对照组，比较2组患者尿常规相关指标，不同肾损伤程度的LN患者尿podocalyxin、Nephrin与肌酸酐比值，采用ROC曲线分析尿podocalyxin、Nephrin与肌酸酐比值诊断LN患者肾损伤程度，并采用回归分析分析尿podocalyxin、Nephrin、肌酸酐比值与LN患者肾损伤程度的相关性。 结果 LN组尿podocalyxin、Nephrin、尿蛋白、血肌酐、Cr、UPx/Cr、UN/Cr、UP/Cr均显著高于对照组，补体C3和C4均显著低于对照组(均P＜0.05)；LN患者UPx/Cr随着ISN/RPS评分增加而显著增加；LN患者UPx/Cr与UN/Cr和ISN/RPS、AI以及CI评分均呈正相关；ROC曲线分析结果显示UPx/Cr的AUC最高，差异具有统计学意义(P＜0.05)；回归分析结果显示UPx/Cr是LN患者肾损伤程度的预测因子。 结论 系统性红斑狼疮肾炎患者尿podocalyxin和Nephrin水平显著增高，UPx/Cr具有作为系统性红斑狼疮肾炎患者肾损伤严重程度的预测因子的潜在价值。 

Correlation between urinary podocalyxin and Nephrin levels and renal injury in patients with systemic lupus erythematosus nephritis

Objective To investigate the correlation between urinary podocalyxin and Nephrin levels and renal injury in patients with systemic lupus erythematosus nephritis (SLE-N). Methods Eighty patients with systemic lupus erythematosus nephritis treated in our hospital from June 2017 to June 2018 were selected as study subjects (LN group), and 80 healthy people in the same period were selected as the control group. The relative indexes of urine routine were compared between the two groups. The urinary podocalyxin and the ratio of Nephrin to creatinine in LN patients with different degree of renal injury were compared. The urinary podocalyxin was analyzed by ROC curve. The ratio of Nephrin to creatinine was used to diagnose the degree of renal injury in patients with LN, and the correlation between the ratio of urinary podocalyxin, Nephrin and creatinine and the degree of renal injury in patients with LN was analyzed by regression analysis. Results Urinary podocalyxin, Nephrin, urine protein and creatinine in LN group were significantly higher than those in the control group (all P<0.05), and the levels of complement C3 and C4 were significantly lower than those in the control group (all P<0.05). The UPx/Cr of LN patients increased significantly with the increase of ISN/RPS score. There was a significant positive correlation between UPx/Cr, UN/Cr with ISN/RPS, AI and CI score in patients with LN. The results of ROC curve analysis showed that the AUC of UPx/Cr was the highest, and the difference was statistically significant compared with the zero hypothesis (P<0.05). Regression analysis showed that UPx/Cr was a significant predictor of renal injury in LN patients. Conclusion The levels of urinary podocalyxin and Nephrin in patients with systemic lupus erythematosus nephritis are significantly higher than those in patients with systemic lupus erythematosus glomerulonephritis and may be a potential predictor of the severity of renal injury in patients with systemic lupus erythematosus nephritis.