姚丽莉　张乾坤　金　烈浙江省丽水市中心医院肾内科，浙江丽水　323000

血管生成抑制蛋白-1对IgA肾病患者预后的影响

姚丽莉张乾坤金烈
浙江省丽水市中心医院肾内科，浙江丽水323000

目的 研究血管生成抑制蛋白-1对IgA肾病患者预后的影响。方法 选择60例IgA肾病患者参与此次前瞻性研究，ELISA法测定血浆血管生成抑制蛋白-1水平，患者定期随访，定义终点事件为终末期肾病（ESRD）或血肌酐（Scr）升高超过100%以上，定义生存时间为患者肾活检至终点事件的时间。结果Kaplan-Meier生存分析显示：血浆血管生成抑制蛋白-1升高者，患者进入终点事件的风险明显高于低水平者（P=0.001）。结论 血管生成抑制蛋白-1是预测IgA肾病患者预后的独立危险因素。

血管生成抑制蛋白-1；IgA肾病；生存分析；终末期肾病

[Abstract]Objective To explore the influence of angiogenesis inhibitor protein-1 on prognosis of IgA nephropathy patients.Methods A total of 60 IgA nephropathy patients were enrolled in the prospective study.The plasma angiogenesis inhibitor protein-1 level was conducted by ELISA.Patients were followed up at regular intervals.The end point event was designed as end-stage renal disease(ESRD)or over 100%enhancement of Scr.The survival time was defined as the time duration from renal biopsy to end point event.Results Kaplan-Meier survival analysis showed that the risk of end point event was significantly higher in patients with increased plasma angiogenesis inhibitor protein-1 level than those with lower level(P=0.001).Conclusion Angiogenesis inhibitor protein-1 is an independent risk factor influencing the prognosis of IgA nephropathy patients.

[Key words]Angiogenesis inhibitor protein-1;IgA nephropathy;Survival analysis;End-stage renal disease

IgA肾病临床及病理改变多种多样，发病后每10年约20%的患者进展到终末期肾病（end-stage renal disease，ESRD），因此寻找早期生物学标记物预测肾功能恶化和避免慢性肾脏病（chroinc kidney disease，CKD）及ESRD进程越来越重要。既往研究显示CKD的发生伴随着肾小球和肾间质毛细血管的增殖和萎缩[1-4]，血管新生（增殖）是指从已有的血管长出新血管的过程，生理和病理状态均可有新生血管形成。血管新生的调节取决于血管生成刺激因子和血管生成抑制因子的平衡，这种平衡出现异常则会导致病理状态的发生而出现疾病。血管生成抑制蛋白-1是迄今为止发现的唯一一个可以被血管内皮细胞生长因子或成纤维细胞生长因子-2诱导的血管生成负反馈抑制因子[5-7]。本研究探讨血管生成抑制蛋白-1对IgA肾病患者预后的影响。……