基于肾活检库IgA 肾病高危病理无创预测模型

MRP

Medical Research and Practice

2993-96902993-9704

Art and Technology

10.61369/MRP.2026090013

Article

基于肾活检库IgA 肾病高危病理无创预测模型https://artdesignp.com/journal/MRP/4/9/10.61369/MRP.2026090013阿卜力孜穆妮热,韩素英,艾尔肯图尔逊姑丽,周姗姗

2026

2026-09-20

目的：构建IgA 肾病高危活动性病理术前无创预测模型，分析肾活检数据库临床病理特征。方法：回顾2021—2024年肾活检资料，352 例患者用于整体特征分析；79例IgA 肾病以Oxford 分型C ≥ 1和/ 或E1定义高危病理终点，经单、多因素Logistic 回归建模，采用ROC、Bootstrap、Brier 评分、Hosmer-Lemeshow 检验评估模型效能。结果：352例不同病理亚组年龄、24h 尿蛋白、eGFR 等指标差异有统计学意义；79例IgA 肾病高危组54例，收缩压、24h尿蛋白更高，白蛋白、C3更低。收缩压、24h 尿蛋白、C3为独立影响因素；模型AUC=0.792，校正AUC=0.758，拟合良好。结论：肾活检数据库可体现术前临床异质性；该三项指标构建的无创模型区分度尚可，可于肾活检前识别高危病理风险。肾活检数据库,IgA 肾病,高危活动性病理,无创预测模型

[1] Lai KN, Tang SCW, Schena FP, Novak J, Tomino Y, Fogo AB, Glassock RJ.IgA nephropathy. Nat Rev Dis Primers. 2016;2:16001.DOI: https://doi.org/10.1038/nr dp.2016.1[2] Working Group of the International IgA Nephropathy Network and the Renal Pathology Society; Cattran DC, Coppo R, Cook HT, Feehally J, Roberts ISD, TroyanovS, et al. The Oxford classification of IgA nephropathy: rationale, clinicopathological correlations, and classification. Kidney Int. 2009;76(5):534-545.DOI: https://doi.org/10.1038/ki.2009.243[3] Trimarchi H, Barratt J, Cattran DC, Cook HT, Coppo R, Haas M, Liu ZH, et al. Oxford Classification of IgA nephropathy 2016: an update from the IgA Nephropathy Classification Working Group. Kidney Int. 2017;91(5):1014-1021.DOI: https://doi.org/10.1016/j.kint.2017.02.003[4] Barbour SJ, Coppo R, Zhang H, Liu ZH, Suzuki Y, Matsuzaki K, et al. Evaluating a New International Risk-Prediction Tool in IgA Nephropathy. JAMA Intern Med. 2019;179(7):942-952.DOI: https://doi.org/10.1001/jamainternmed.2019.0600[5] 刘春花, 杨定平. 伴不同比例新月体IgA 肾病患者的临床病理特征及预后分析[J]. 临床肾脏病杂志,2024,24(1):51-60.DOI:10.3969/j.issn.1671-2390.2024.01.008.[6] Poggio ED, McClelland RL, Blank KN, Hansen S, Bansal S, Bomback AS, et al. Systematic Review and Meta-Analysis of Native Kidney Biopsy Complications. Clin J Am Soc Nephrol. 2020;15(11):1595-1602.DOI: https://doi.org/10.2215/CJN.04710420.[7] Stamellou E, Seikrit C, Tang SCW, Boor P, Tesař V, Floege J, Barratt J, Kramann R. IgA nephropathy. Nat Rev Dis Primers. 2023;9(1):67.DOI: https://doi. org/10.1038/s415 72-023- 00476-9.[8] 彭思琪, 卢文, 江肖, 徐兴欣, 吴永贵.742例原发性IgA 肾病患者的临床病理特征及其预后分析[J]. 中华肾脏病杂志,2021,37(2):87-94.DOI:10.3760/cma.j.cn441217-20200407-00016.[9] Tang C, Chen P, Si FL, Lv JC, Shi SF, Zhou XJ, Liu LJ, Zhang H. Time-Varying Proteinuria and Progression of IgA Nephropathy: A Cohort Study. Am J Kidney Dis. 2024;84(2):170-178.e1.DOI: https://doi.org/10.1053/j.ajkd.2023.12.01