| Objective:Idiopathic membranous nephropathy(IMN)is the main cause of adult nephrotic syndrome.The prognosis of different patients is significantly different,and the risk factors for prognosis are still controversial.In this experiment,we studied the expression of new cardiac markers Growth differentiation factor-15(GDF-15),Soluble suppression of tumorigenicity(sST-2)and other conventional biochemical indicators in IMN patients and their subgroups,and their correlation with the severity of IMN disease to construct a new risk prediction tool Therefore,the risk stratification of patients can be performed early,and the prognosis outcomes of IMN patients can be assessed more accurately,thereby helping clinicians to choose relatively appropriate treatment strategies.Methods: Collected 79 patients who were treated in our hospital from November 2014 to July 2019.The pathological diagnosis was idiopathic membranous nephropathy with a follow-up period of 12 months and complete clinical data.A total of 79 patients received standardized treatment with hormone and cyclophosphamide.Forty-one patients were tested for serum GDF-15,sST-2,PLA2R-Ab levels and other conventional biochemical indicators,and their expression characteristics in healthy control groups,IMN groups and their subgroups were analyzed;GDF-15,sST-2.The correlation between PLA2R-Ab and other indicators that reflect renal impairment in patients with IMN,and study its correlation with the condition of patients with IMN;obtain an independent prediction of whether IMN is completely resolved in the factors in this study through logistic multivariate regression analysis Factor,further evaluate its prediction effectiveness through the ROC curve,and combine independent predictor variables to build a new risk prediction tool.Results: 1.Serum GDF-15,sST-2,Cys-C,TC,HDL-C,LDL-C,apoA1,apoB,RDW-CV,and WBC levels in the IMN group were significantly higher than those in the healthy control group.,Hb were lower than those in healthy controls.2.The levels of GDF-15 and sST-2 were significantly higher in the low eGFR group than in the high eGFR group;the levels of PLA2R-Ab and GDF-15 in the large proteinuria group were significantly higher than those in the small proteinuria group.In addition,the low eGFR group showed more male patients,older patients,and higher serum Urea,TC,and Hb levels.A large number of proteinuria groups showed higher levels of TC,LDL-C,apoB,and lower levels of Alb.3.There was a significant correlation between GDF-15,sST-2,and other indicators of PLA2R-Ab reflecting renal impairment.4.PLA2R-Ab,Cr,Urea,24h-UP,HDL-C,and NCare independently related to the complete remission of the disease.Based on these six independent risk factors,a post-combination prediction tool is obtained: joint factor =0.040×PLA2R-Ab+1.254×Urea-0.072×Cr-2.220×HDL-C+0.197×24h-UP+6.925×N C.Among them,PLA2R-Ab,24h-UP,and combined factors have a good evaluation effect on the complete remission of IMN patients.Conclusion: Serum GDF-15,ST-2 and PLA2R-Ab levels in IMN patients can reflect the severity of renal function damage in IMN patients,and are significantly related to other indicators of renal damage,which is expected to be a potential biomarker for the severity of IMN disease;PLA2R-Ab,Cr,Urea,24h-UP,HDL-C,and WBC are independent predictors of complete remission in patients with IMN.PLA2 R,24h-UP,and a combination factor(combination factor = =0.040×PLA2R-Ab +1.254×Urea-0.072×Cr-2.220×HDL-C+0.197×24h-UP+6.925×NC)has shown a good evaluation performance for the complete remission of IMN patients. |
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