抗M型磷脂酶A2受体抗体对原发性膜性肾病患者疾病缓解的预测价值

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Abstract Objective To explore the predictive value of anti-M-phospholipase A2 receptor (PLA2R) antibody in the remission of primary membranous nephropathy (PMN) patients one year after treatment. Methods One hundred and six patients with PMN treated in our hospital from January 2020 to January 2023 were divided into remission group (72 cases) and non-remission group (34 cases) according to whether the disease was relieved one year after treatment. The clinical data of the two groups were compared, and the correlation between anti-PLA2R antibody and non-remission of PMN patients after treatment was analyzed. Logistic regression analysis was used to identify the independent influencing factors of non-remission of PMN patients after treatment, and the ROC curve of subjects was drawn to analyze the predictive value of anti-PLA2R antibody for non-remission of PMN patients after treatment. The independent influencing factors obtained were incorporated into the nomogram prediction model, and the effectiveness of the nomogram model was evaluated by C index, ROC curve and calibration curve in R software. Results Compared with the clinical data of the two groups, the age, 24hUP and anti-PLA2R antibody in remission group were lower than those in non-remission group, while eGFR and ALB in remission group were higher than those in non-remission group, with statistical significance. There was no difference in other clinical data. After one year’s treatment of PMN patients, Chi-square test and Kendall’s tau-b correlation analysis showed that anti-PLA2R antibody was positively correlated with 24-hour UP and negatively correlated with eGFR and ALB. Logistic regression analysis showed that high level of 24-hour UP and anti-PLA2R antibody and low level of ALB were independent risk factors for PMN patients who were not relieved after one year of treatment. The ROC curve was drawn, and the result showed that the AUC value of anti-PLA2R antibody level was 0.957, which indicated that anti-PLA2R antibody had a good predictive value for the remission of PMN patients after one year of treatment. A nomogram model was constructed to predict the unresponsiveness of PMN patients after one year of treatment. The verified results showed that the C-index value of the calibration curve was 0.950, the AUC of the ROC curve modeling group was 0.950, and the AUC of the verification group was 0.969, which indicated that the nomogram model had good predictive energy efficiency and discriminating ability. Conclusion The level of anti-PLA2R antibody is related to 24-hour UP and ALB. Anti-PLA2R antibody is an independent factor that affects the remission of PMN patients after treatment. The higher the level of anti-PLA2R antibody, the worse the prognosis of PMN patients.

Key words： anti-M-type phospholipase a 2 receptor primary membranous nephropathy prognosis nomogram model

Received: 05 June 2024

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	ZHANG Lan
	WANG Liyuan

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ZHANG Lan,WANG Liyuan. Predictive value of anti-M-phospholipase A2 receptor antibody for disease remission in patients with primary membranous nephropathy[J]. HuNan ShiFan DaXue XueBao(YiXueBan), 2024, 21(4): 150-155.

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http://yxb.hunnu.edu.cn/EN/ OR http://yxb.hunnu.edu.cn/EN/Y2024/V21/I4/150

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