摘要
目的:探讨血清抗磷脂酶A2受体(PLA2R)抗体及肾组织PLA2R在特发性膜性肾病(IMN)的表达及与临床指标的相关性。方法:选取139例经肾穿刺活检证实的肾小球疾病患者为研究对象,包括IMN、继发性膜性肾病(SMN)及除膜性肾病(MN)以外的其他病理类型。检测血清抗PLA2R抗体及肾组织PLA2R;Spearman相关分析法分析IMN患者血清抗PLA2R抗体与临床指标的相关性;比较IMN患者血清抗PLA2R抗体不同滴度组实验室指标的差异。结果:35例IMN患者中,血清抗PLA2R抗体阳性24例,占68.57%;肾组织PLA2R阳性29例,占82.86%;两者均阳性24例,约占68.57%;两者均阴性6例,约占17.14%;血清抗PLA2R抗体阴性而肾组织PLA2R阳性5例,约占14.29%。SMN及其余非MN患者两者均为阴性。相关性分析显示,血清抗PLA2R抗体与血清白蛋白呈负相关(P<0.05)。低滴度组白蛋白为(24.22±6.27)g/L,高滴度组白蛋白为(19.86±3.31)g/L,两组差异有统计学意义(P<0.05)。低滴度组总胆固醇中位数为7.04(5.65~9.05)mmol/L,高滴度组总胆固醇中位数为8.37(7.17~9.87)mmol/L,两组差异有统计学意义(P<0.05)。结论:IMN中血清抗PLA2R抗体及肾组织PLA2R的表达中等一致;血清抗PLA2R抗体对诊断IMN有较大参考意义;血清抗PLA2R抗体与白蛋白有相关性,且滴度的高低可一定程度上反映IMN的疾病活动度。
Objective:To examine the expression of serum anti-phospholipase A2 receptor(PLA2 R)antibody and the expression of renal PLA2 R in idiopathic membranous nephropathy(IMN),analyze the correlation between serum anti-PLA2 R antibody and clinical indicators.Methods:139 patients with glomerular disease confirmed by renal biopsy were enrolled,including IMN,secondary membranous nephropathy(SMN)and other pathological types except MN.Serum anti-PLA2 R antibody and renal PLA2 R were detected.Spearman correlation analysis was used to analyze the correlation between serum anti-PLA2 R antibody and clinical indicators in patients with IMN.The differences in laboratory indicators between the low-titer and high-titer serum anti-PLA2 R antibody groups were compared.Results:Among the 35 IMN patients,24(68.57%)were positive for anti-PLA2 R antibody,29(82.86%)were positive for renal PLA2 R,both of them were positive in 24 cases(68.57%),and both were negative in 6 cases(17.14%),5(14.29%)were negative serum anti-PLA2 R antibody and positive renal PLA2 R.In SMN and other non-MN patients,both were negative.Correlation analysis showed that serum anti-PLA2 R antibody was negatively correlated with serum albumin(P<0.05).The albumin in the low titer group was(24.22±6.27)g/L,and the albumin in the high titer group was(19.86±3.31)g/L,there was statistical difference between the two groups(P<0.05).The median total cholesterol in the low titer group was 7.04(5.65~9.05)mmol/L,the median total cholesterol in the high titer group was 8.37(7.17~9.87)mmol/L,there was statistical difference between the two groups(P<0.05).Conclusion:The expression of serum anti-PLA2 R antibody and renal PLA2 R in IMN is moderately consistent.The serum anti-PLA2 R antibody has great reference significance for the diagnosis of IMN.Serum anti-PLA2 R antibody is related to albumin,and the titer can reflect the disease activity of IMN to a certain extent.
作者
陈利佳
王少清
毛楠
CHEN Li-jia;WANG Shao-qing;MAO Nan(The First Affiliated Hospital of School of Clinical Medical,Chengdu Medical College,Chengdu 610500,Sichuan,China)
出处
《川北医学院学报》
CAS
2022年第9期1207-1210,共4页
Journal of North Sichuan Medical College
基金
四川省中医药管理局课题(2020LC0072)
四川省成都市金牛区医学会肾脏内科专委会专项科研课题(JNZD20-12)。
