白蛋白与球蛋白比率作为狼疮性肾炎患者预后预测指标的分析

St. Sandra Karyati Serel, Yuyun Widaningsih, Fitriani Mangarengi
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摘要

狼疮性肾炎(LN)是系统性红斑狼疮(SLE)的一种表现,主要侵犯肾脏。世界卫生组织根据组织病理学将该病分为五类:正常型、间质型、局灶型、弥漫增生型和膜型。白蛋白与球蛋白比值(AGR)比较血清白蛋白和血清球蛋白水平。AGR 值低与癌症、肝硬化等疾病以及 LN 等其他慢性炎症性疾病的预后不良有关。本研究旨在采用回顾性描述性横断面方法,根据疾病分级分析 AGR 值作为 LN 患者预后预测指标的作用。研究对象共 109 人,包括 1 级(15 人)、2 级(37 人)、3 级(9 人)、4 级(21 人)和 5 级 LN(27 人)。收集了疾病等级、血清白蛋白和血清球蛋白/总蛋白水平的数据。统计分析采用 SPSS 25 版、Mann-Whitney、Kruskal-Wallis、Chi-Square 和 Spearman 相关性检验。根据 ROC 曲线确定临界值。如果 p <0.05,则测试结果具有显著性。第 4 级 LN 的平均 AGR 值最低(0.79)(p<0.05)。AGR 的最佳临界值为 1.10,用于划分轻度、中度和重度。AGR 的预后价值:敏感性=95.8%;特异性=78.8%;阳性预测值(PPV)=78.0%;阴性预测值(NPV)=96.0%,准确性=86.2%。AGR 值与 LN 等级呈强负相关,相关系数 R 为-0.777(P<0.001)。作为 LN 进展的预测指标,AGR 标记具有良好的灵敏度和特异性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of Albumin to Globulin Ratio as A Prognostic Predictor in Lupus Nephritis Patients
Lupus Nephritis (LN) is a manifestation of Systemic Lupus Erythematosus (SLE), which targets the kidney. Based on histopathology, the World Health Organization divides the disease into five classes: normal pattern, mesangial, focal, diffuse proliferative, and membranous. Albumin to Globulin Ratio (AGR) compares serum albumin with serum globulin levels. Low AGR value is associated with poor prognosis of diseases such as cancer, liver cirrhosis, and other chronic inflammatory diseases such as LN. This study aimed to analyze the AGR value as a prognostic predictor in LN patients based on disease classes with a retrospective descriptive cross-sectional approach. Total subjects were 109, which consisted of class 1 (n=15), class 2 (n=37), class 3 (n=9), class 4 (n=21), and class 5 LN (n=27). Data of disease classes, serum albumin, and serum globulin/total protein levels were collected. SPSS version 25, Mann-Whitney, Kruskal-Wallis, Chi-Square, and Spearman's correlation test were used for statistical analysis. The ROC curve determined the cut-off. Test results were significant if p <0.05. The lowest mean AGR value (0.79) was found in class 4 LN (p<0.05). The optimal cut-off AGR was 1.10 to categorize mild-moderate and severe degrees. AGR prognostic value: sensitivity=95.8%; specificity=78.8%; Positive Prediction Value (PPV)=78.0%; Negative Prediction Value (NPV)=96.0%, accuracy = 86.2%. There was a negative strong correlation between the AGR value and LN class with a correlation coefficient R of -0.777 (p<0.001). AGR marker has a good sensitivity and specificity as a predictor of LN progression.
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