| Objectives:Detecting the serum Gd-IgA1 concentration and the percentage of peripheral blood memory B cells in IgAN patients to explore the relationship between the two;To explore the value of serum Gd-IgA1 in the diagnosis of IgAN;To study the relationship between serum Gd-IgA1 and peripheral blood memory B cells and clinical and pathological indicators.Methods:A total of 40 patients(IgAN group)who were admitted to the nephrology department of The Northern Jiang Su People’s Hospital from December 2019 to December 2020 and were diagnosed as primary IgAN by renal biopsy for the first time and met the inclusion criteria were selected;20 patients(Non-IgAN group)with other glomerulonephritis who were excluded from primary and secondary IgAN by renal biopsy and met the inclusion criteria were selected;15 healthy people(healthy control group)with matched age distribution and no obvious abnormalities in related biochemical indicators in the physical examination department of The Northern Jiang Su People’s Hospital during the same period were selected.We collected the general data such as gender,age and MAP;the clinical biochemical data including hemoglobin(g/L),serum creatinine(umol/L),urea nitrogen(mmol/L),serum uric acid(umol/L),serum albumin(g/L),triglyceride(mmol/L)and total cholesterol(mmol/L);urinary erythrocyte count(per/u L),24 h urinary protein(g/24h);e GFR(m L/min/1.73m2)was calculated according to MDRD simplified formula;Oxford classification(MESTC score)and Lee’s classification pathological data of IgAN group were collected;renal pathological data of Non-IgAN group were collected.We collected the peripheral venous blood samples of the three groups and then detected the concentration of Gd-IgA1 and the percentage of memory B cells in peripheral blood.Correlation analysis was used to explore the relationship between serum Gd-IgA1 and peripheral blood memory B cells;the value of serum Gd-IgA1 in the diagnosis of IgAN was analyzed by drawing ROC curve and calculating the area under the curve;the relationship between serum Gd-IgA1 and memory B cells and above clinical and pathological indicators was also analyzed by correlation analysis.Results:1.The serum Gd-IgA1 of IgAN group was 16.83(12.68,17.91)ug/ml,significantly higher than that of Non-IgAN group 12.02(10.54,16.40)ug/ml(P=0.015<0.05)and healthy control group 12.04(8.91,16.21)ug/ml(P=0.008<0.01).2.The percentage of peripheral blood memory B cells of IgAN group was 28.24±9.29%,which was significantly higher than that of Non-IgAN group19.83±8.16%(P=0.015<0.05)and healthy control group 18.76±8.78%(P=0.004<0.01)3.There was a positive correlation between serum Gd-IgA1 and peripheral blood memory B cells of IgAN group(r=0.393,P=0.039<0.05).4.The AUC of serum Gd-IgA1 in the diagnosis of IgAN was 0.763,and the sensitivity and specificity were 88% and 53% respectively when the cut-off value was 12.05ug/ml;when serum Gd-IgA1 >12.05ug/ml,it has a high sensitivity in the diagnosis of IgAN.5.Serum Gd-IgA1 was positively correlated whit urinary erythrocyte count in IgAN group(r=0.375,P=0.017<0.05);positively correlated with C(r=0.336,P=0.01<0.05),the serum Gd-IgA1 of C1 group was 17.36(16.46,18.22)ug/ml,which was significantly higher than that of C0 group 15.20(12.10,17.13)ug/ml.There was no correlation with age,MAP,hemoglobin,serum creatinine,urea nitrogen,serum albumin,uric acid,e GFR,triglyceride,total cholesterol,24 h urinary protein,M,E,S,T and Lee’s classification pathological indicators.6.There was a positive correlation between peripheral blood memory B cells and urinary erythrocyte count in IgAN group(r=0.515,P=0.008<0.01).There was no correlation with age,MAP,hemoglobin,serum creatinine,urea nitrogen,serum albumin,uric acid,e GFR,triglyceride,total cholesterol,24 h urinary protein,M,E,S,T,C and Lee’s classification pathological indicators(P>0.05).Conclusions:1.The production of serum Gd-IgA1 may be related to the expression of peripheral blood memory B cells.2.Serum Gd-IgA1 has a certain reference significance for the diagnosis of IgAN,it was positively correlated with urinary erythrocyte count and C,which had certain significance in assessing disease condition and monitoring disease progression.3.There was a positive correlation between the percentage of peripheral blood memory B cells and urinary erythrocyte count,indicated that memory B cells had certain value in assessing disease condition and monitoring disease progression. |
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