血清CCL5、CCL13在儿童IgA血管炎早期肾损伤中的预测价值

doi:10.3870/j.issn.1672-8009.2026.03.007

摘要/Abstract

摘要： 目的探讨IgA血管炎(IgA vasculitis,IgAV)患儿血清中趋化因子(C-C基元)配体5[chemokine(C-C motif)ligand 5,CCL5]与趋化因子(C-C基元)配体13[chemokine(C-C motif)ligand 13,CCL13]在早期发生肾损伤中的预测价值。方法选取2023年1月至2025年3月于中国人民解放军联勤保障部队第九四○医院接受治疗的267例IgAV患儿作为研究对象,并根据是否发生肾损伤分为IgA血管炎性肾炎(immunoglobulin A vasculitis with nephritis,IgAVN)组(n=94)与IgAV组(n=173)。收集两组患儿的临床资料。采用酶联免疫吸附试验检测血清中CCL5、CCL13水平,Spearman相关性分析明确IgAVN患儿血清CCL5、CCL13水平的相关性,比较CCL5、CCL13水平与IgAVN临床分型的关系,多因素Logistic回归分析IgAV患儿早期发生肾损伤的危险因素,并基于此构建列线图模型。绘制ROC曲线、校准曲线及决策曲线以评估模型的预测效能。ROC曲线分析血清中CCL5、CCL13水平在评估IgAV患儿早期发生肾损伤的预测价值。结果与IgAV组相比,IgAVN组年龄、中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)均显著升高(P_均＜0.05)。与IgAV组相比,IgAVN组血清CCL5、CCL13水平均显著升高(P_均＜0.05)。Spearman相关性分析显示,IgAVN组患儿血清CCL5、CCL13水平呈显著正相关(r=0.339,P＜0.001)。不同临床分型的IgAVN患儿血清CCL5和CCL13水平存在差异且随病情严重程度增加(P<0.05)。多因素Logistic回归分析结果显示,年龄升高、NLR升高、血清CCL5和CCL13水平升高均为IgAV患儿早期发生肾损伤的独立危险因素。基于Logistic回归分析结果构建的列线图模型预测效能显著,具有较好的临床应用潜力。ROC曲线分析结果显示,血清中CCL5、CCL13水平能够作为诊断IgAV患儿早期发生肾损伤的有效指标。结论血清CCL5、CCL13水平升高与IgAV患儿早期肾损伤密切相关,联合检测其水平对于评估早期发生肾损伤具有较高价值。

关键词: IgA血管炎, IgA血管炎性肾炎, CCL5, CCL13, 肾损伤, 预测价值

Abstract: Objective To investigate the predictive value of serum chemokine(C-C motif)ligand 5(CCL5)and chemokine(C-C motif)ligand 13(CCL13)for early renal injury in children with IgA vasculitis(IgAV). Methods A total of 267 children with IgAV treated at the 940th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army from January 2023 to March 2025 were enrolled.According to the presence or absence of renal injury,they were divided into an IgA vasculitis with nephritis(IgAVN)group(n=94)and an IgAV-without-nephritis group(n=173).Clinical data were collected.Serum CCL5 and CCL13 levels were measured by enzyme-linked immunosorbent assay.Spearman correlation was used to evaluate the relationship between CCL5 and CCL13 in IgAVN patients.Differences in CCL5 and CCL13 among IgAVN clinical subtypes were compared.Multivariate logistic regression was performed to identify independent risk factors for early renal injury in children with IgAV,and a nomogram was constructed.ROC curves,calibration curves,and decision-curve analysis were used to assess the model’s predictive performance.ROC curve analysis was also used to evaluate the diagnostic value of serum CCL5 and CCL13 for early renal injury. Results The IgAVN group showed significantly older age and higher neutrophil-to-lymphocyte ratio(NLR)than the IgAV group(both P<0.05).Serum CCL5 and CCL13 levels were also markedly elevated in the IgAVN group(both P<0.05).Spearman analysis revealed a significant positive correlation between serum CCL5 and CCL13 in IgAVN patients(r=0.339,P<0.001).CCL5 and CCL13 levels differed among IgAVN clinical subtypes and increased with disease severity(P<0.05).Multivariate logistic regression indicated that increased age,elevated NLR,and higher serum CCL5 and CCL13 levels were independent risk factors for early renal injury in children with IgAV.The nomogram based on these factors demonstrated good predictive performance and clinical utility.ROC curve analysis showed that serum CCL5 and CCL13 were effective biomarkers for diagnosing early renal injury in children with IgAV. Conclusion Elevated serum CCL5 and CCL13 levels are closely associated with early renal injury in pediatric IgAV patients.Combined detection of these markers holds significant value for assessing the occurrence of early renal injury.

Key words: immunoglobulin A vasculitis, immunoglobulin A vasculitis with nephritis, chemokine(C-C motif)ligand 5, chemokine(C-C motif)ligand 13, renal injury, predictive value

中图分类号:

R725.5

王飞, 曾繁霞, 赵晓云, 梁玲, 郭林梅. 血清CCL5、CCL13在儿童IgA血管炎早期肾损伤中的预测价值[J]. 医学分子生物学杂志, 2026, 23(3): 285-293.

WANG Fei, ZENG Fanxia, ZHAO Xiaoyun, LIANG Ling, GUO Linmei. Predictive Value of Serum CCL5 and CCL13 for Early Renal Injury in Children with Immunoglobulin A Vasculitis[J]. Journal of Medical Molecular Biology, 2026, 23(3): 285-293.

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