抗中性粒细胞胞浆抗体相关性肾小球肾炎患者中血清可溶性CD206与疾病活动度间相关性

doi:10.16150/j.1671-2870.2026.03.012

诊断学理论与实践 ›› 2026, Vol. 25 ›› Issue (03): 354-360.doi: 10.16150/j.1671-2870.2026.03.012

抗中性粒细胞胞浆抗体相关性肾小球肾炎患者中血清可溶性CD206与疾病活动度间相关性

魏兆楠¹^,², 安晓宁¹, 倪莉燕¹, 沈平雁¹, 史浩¹, 张文¹, 陈永熙¹()

¹ 上海交通大学医学院附属瑞金医院肾脏科，上海 200025
² 苏州大学附属第二医院肾内科，苏州 215004

收稿日期:2025-09-07 修回日期:2025-12-02 接受日期:2025-12-03 出版日期:2026-06-25 发布日期:2026-06-27
通讯作者: 陈永熙 E-mail： rickychen@sjtu.edu.cn
作者简介:作者贡献/Authors’ Contributions
魏兆楠，安晓宁负责实验研究、数据分析，魏兆楠负责文章撰写，倪莉燕负责ANCA以及临床标本检验，沈平雁、史浩和张文负责临床标本收集，陈永熙负责数据核对以及文章审核。
基金资助:
国家自然科学基金(81000285);国家自然科学基金(81470041);国家自然科学基金重点国际（地区）合作研究项目(82120108007);国家转化医学研究中心（上海）开放课题(TMSK-2024-101);国家转化医学研究中心（上海）开放课题(NRCTM（SH）-2025-10（瑞金基地）)

Correlation between serum soluble CD206 and disease activity in patients with anti-neutrophil cytoplasmic antibody-associated glomerulonephritis

WEI Zhaonan¹^,², AN Xiaoning¹, NI Liyan¹, SHEN Pingyan¹, SHI Hao¹, ZHANG Wen¹, CHEN Yongxi¹()

¹ Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
² Department of Nephrology, Second Affiliated Hospital, Soochow University, Suzhou 215004, China

Received:2025-09-07 Revised:2025-12-02 Accepted:2025-12-03 Published:2026-06-25 Online:2026-06-27

摘要/Abstract

摘要：

目的：探究血清可溶性CD206（serum soluble CD206， sCD206）水平在抗中性粒细胞胞浆抗体（anti-neutrophil cytoplasmic antibodies， ANCA）相关性肾小球肾炎（ANCA associated glomerulonephritis， AGN）患者中的表达特征，及其对疾病活动度的评估价值。方法：连续招募2020年1月至2022年12月期间于上海交通大学医院附属瑞金医院肾脏科住院治疗的54例AGN患者，所有患者均符合Chapel Hill Consensus Conference 2012诊断标准。AGN患者住院期间，共收集活动期AGN患者血清标本38例、缓解期AGN患者血清标本29例，其中13例患者同时提供了活动期和缓解期标本。另招募14名年龄、性别匹配的健康志愿者作为对照。采用双抗体夹心酶联免疫吸附试验（enzyme linked immunosorbent assay， ELISA）测定所有研究对象的血清sCD206水平，比较健康志愿者、活动期AGN患者与缓解期AGN患者3组间的差异，并对13例在研究期间达到临床缓解的活动期患者，进行其活动期与缓解期标本的配对分析。分析血清sCD206水平与AGN相关临床指标[血清肌酐、估算肾小球滤过率（estimated glomerular filtration rate， eGFR）、24 h尿蛋白、伯明翰血管炎活动性评分（Birmingham vasculitis activity score，BVAS）、红细胞沉降率等]之间的相关性，并通过受试者操作特征（receiver operator characteristic， ROC）曲线分析血清sCD206水平评估AGN疾病缓解的效能。结果：活动期AGN患者的sCD206水平[（2.359±0.827） AU]显著高于缓解期患者[（0.989±0.230） AU]及健康对照者[（1.074±0.528） AU]（P均<0.000 1），同一患者缓解期的血清sCD206水平较活动期显著下降（ΔsCD206=1.439±0.873，P<0.01），而缓解期AGN患者的血清sCD206水平与健康对照者间没有差异（P>0.05）。血清sCD206水平与临床指标间的相关性分析结果显示，活动期AGN患者的血清sCD206水平与BVAS呈显著正相关（r=0.577，P<0.001）。ROC曲线分析显示，血清sCD206水平预测AGN患者临床缓解的曲线下面积为0.876，最佳临界值为1.547 AU，此时的灵敏度为86.21%，特异度为78.95%。结论：AGN患者的血清sCD206水平随疾病活动度下降而显著降低，可作为评估AGN患者临床缓解的潜在标志物。

关键词: 可溶性CD206, 抗中性粒细胞包浆抗体, 肾小球肾炎

Abstract:

Objective This study aims to investigate the expression characteristics of serum soluble CD206 (sCD206) in patients with anti-neutrophil cytoplasmic antibodies (ANCA)-associated glomerulonephritis (AGN) and its value in assessing disease activity. Methods A total of 54 AGN patients hospitalized in the Department of Nephrology of Ruijin Hospital from January 2020 to December 2022 were consecutively enrolled, and 38 active-phase serum specimens and 29 remission-phase specimens for each were collected. Among them, 13 patients provided both active-phase and remission-phase serum specimens. Additionally, 14 age- and sex-matched healthy volunteers were recruited as controls. Serum sCD206 levels of all subjects were measured using double-antibody sandwich enzyme-linked immunosorbent assay (ELISA). Comparisons were made among healthy controls, active-phase AGN patients, and remission-phase AGN patients. Paired analysis was performed on active-phase and remission-phase specimens from the 13 patients who achieved clinical remission during the study period. Correlations between serum sCD206 levels and AGN-related clinical indicators [serum creatinine, estimated glomerular filtration rate (eGFR), 24-hour urinary protein, Birmingham Vasculitis Activity Score (BVAS), erythrocyte sedimentation rate, etc.] were analyzed. The efficacy of serum sCD206 levels on assessing disease remission in AGN was evaluated using receiver operating characteristic (ROC) curve. Results Serum sCD206 levels in active-phase AGN patients [(2.359±0.827) AU] were significantly higher than those in remission-phase patients [(0.989±0.230) AU] and healthy controls [(1.074±0.528) AU] (all P<0.000 1). The serum sCD206 levels of the same patients during the remission phase were significantly lower than those during the active phase (ΔsCD206=1.439±0.873 AU, P<0.01). There was no significant difference in serum sCD206 levels between remission-phase AGN patients and healthy controls (P>0.05). Correlation analysis showed that serum sCD206 levels in active-phase AGN patients were positively correlated with BVAS (r=0.577, P<0.001). ROC curve analysis showed that the area under the curve (AUC) of serum sCD206 levels for assessing clinical remission in AGN patients was 0.876. The optimal cutoff value was 1.547 AU, with a sensitivity of 86.21% and a specificity of 78.95%. Conclusions Serum sCD206 levels decrease significantly as disease activity declines, and can serve as a potential biomarker for evaluating clinical remission in AGN patients.

Key words: Soluble CD206, Anti-neutrophil cytoplasmic antibodies, Glomerulonephritis

中图分类号:

魏兆楠, 安晓宁, 倪莉燕, 沈平雁, 史浩, 张文, 陈永熙. 抗中性粒细胞胞浆抗体相关性肾小球肾炎患者中血清可溶性CD206与疾病活动度间相关性[J]. 诊断学理论与实践, 2026, 25(03): 354-360.

WEI Zhaonan, AN Xiaoning, NI Liyan, SHEN Pingyan, SHI Hao, ZHANG Wen, CHEN Yongxi. Correlation between serum soluble CD206 and disease activity in patients with anti-neutrophil cytoplasmic antibody-associated glomerulonephritis[J]. Journal of Diagnostics Concepts & Practice, 2026, 25(03): 354-360.

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参考文献 23

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Item	Patients with active vasculitis	Patients with remissive vasculitis
Sex
Male[n（%）]	20（52.63%）	9（31.03%）
Female[n（%）]	18（47.37%）	20（68.97%）
Age（year）	66（59-71）	67（61-71）
Serum creatinine（μmol/L）	309（173-466）	123（89-180）
eGFR（mL/min）	17.00（9.55-31.65）	47.30（28.80-68.10）
Proteinuria（mg/24 h）	1 990（1 240-3 048）	398（151-637）

Item	serum sCD206
Item	r	P
Serum creatinine	-0.002	0.988
eGFR	-0.132	0.437
MPO-ANCA titer	0.058	0.735
Erythrocyte sedimentation rate	-0.082	0.654

Item	Active patients (BVAS>0)	Remissive patients (BVAS=0)	Total
sCD206 positive (≥1.547)	25	8	33
sCD206 negative (<1.547)	4	30	34
Total	29	38

抗中性粒细胞胞浆抗体相关性肾小球肾炎患者中血清可溶性CD206与疾病活动度间相关性

Correlation between serum soluble CD206 and disease activity in patients with anti-neutrophil cytoplasmic antibody-associated glomerulonephritis

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