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目的探讨血清B细胞活化因子(BAFF)水平对于评估IgA肾病严重程度以及预后的意义。方法 93例肾活检病理证实为原发性IgA肾病的患者被纳入研究,25例年龄及性别相匹配的健康人作为健康对照。根据Lee氏分级,将IgA肾病患者进一步分为三组。血清BAFF水平通过ELISA进行检测。结果 IgA肾病患者血清中BAFF水平明显高于正常对照组。Lee氏分级Ⅳ～Ⅴ级的患者血清BAFF水平明显高于Lee氏分级为Ⅲ级者,而Lee氏分级Ⅲ级者明显高于Lee氏分级为Ⅰ～Ⅱ级者。血清BAFF水平与IgA肾病的临床预后因子(肾功能、蛋白尿、高血压)以及病理预后预测因子(系膜增生、肾小球节段硬化、内皮细胞增生、肾小管/间质损害)明显相关。结论血清BAFF能够反映IgA肾病疾病严重程度,可望作为预测IgA肾病预后的生物标记物。BAFF可能参与IgA肾病的发病及进展。但我们的结论尚需进一步研究验证。
Objective To investigate the significance of serum B-cell activating factor (BAFF) in assessing the severity and prognosis of IgA nephropathy. Methods Ninety-three patients with pathologically confirmed renal primary IgA nephropathy were enrolled in the study. Twenty-five healthy individuals of the same age and gender were selected as healthy controls. According to Lee’s classification, IgA nephropathy patients were further divided into three groups. Serum BAFF levels were measured by ELISA. Results The level of BAFF in serum of patients with IgA nephropathy was significantly higher than that of the normal control group. The serum levels of BAFF in Lee patients with grade Ⅳ ~ Ⅴ were significantly higher than those with Lee patients in grade Ⅲ, while Lee patients with grade Ⅲ were significantly higher than those with Lee in grades Ⅰ ~ Ⅱ. Serum BAFF levels were significantly associated with clinical prognostic factors of IgA nephropathy (renal function, proteinuria, hypertension) and predictors of pathologic prognosis (mesangial proliferation, segmental glomerulosclerosis, endothelial cell proliferation, tubulointerstitial damage) . Conclusion Serum BAFF can reflect the severity of IgA nephropathy and is expected to be a biomarker to predict the prognosis of IgA nephropathy. BAFF may be involved in the pathogenesis and progression of IgA nephropathy. However, our conclusion still needs further study and verification.