急进性肾炎中抗肾小球基底膜抗体的检测及其临床意义  

Anti-glomerular basement membrane autoantibodies in Chinese patients with rapidly progressive glomerulonephritis and their clinical relevance

作　　者：刘娜[1,2] 赵明辉[1,2] 章友康[1,2] 郑欣[1,2] 王海燕[1,2] 

机构地区：[1]北京医科大学第一医院肾内科,100034 [2]北京医科大学第一医院肾脏病研究所,100034

出　　处：《中华肾脏病杂志》1998年第5期292-295,共4页Chinese Journal of Nephrology

摘　　要：目的了解急进性肾炎(RPGN)中抗肾小球基底膜(GBM)抗体的发生率及其临床意义。方法自行制备可溶性人GBM抗原,应用酶联免疫吸附方法(ELISA)对29例RPGN患者进行抗GBM抗体的检测,并对阳性血清用免疫印迹法进行鉴定、验证。结果 29例RPGN患者中5例抗GBM抗体阳性,占17%,其中一例伴ANCA阳性。免疫印迹法证实均识别23-27KD,40-54KD的蛋白条带。3/4例免疫荧光呈现免疫复合物细颗粒样沿GBM沉积。结论抗GBM抗体型RPGN在我国并不少见,用ELISA法检测抗GBM抗体特异性高而且较间接免疫荧光方法(IIF)更灵敏。应早期对所有RPGN患者进行常规抗GBM抗体检测。Objective To determine the prevalence of autoantibodies against glomerular basement membrane(GBM) in sera of Chinese patients with rapidly progressive glomerulonephritis(RPGN)and to evaluate their clinical relevance. Methods Serum anti-GBM antibodies were detected in 29 RPGN patients by enzyme-linked immunoassay(ELISA)using collagenase solublized human GBM as solid phase ligand. Positive sera were also oonfirmed by Western blot analysis. Results Of the 29 RPGN patients, 5(17%)were positive for anti-GBM autoantibodies. One positive for both anti-GBM autoantibody and ANCA. On Western blot analysis. 23 000～27 000 and 40 000～54 000 polypeptides could be blotted. On direct immunofluoresence there were granular deposits of immunocomplex in capillary loops in three of four. Conclusions The prevalence of anti-GBM antibody mediated RPGN is not rare in China. Using ELISA to detect circulating anti-GBM autoantibodies had been proved to be a more specific and sensitive methods. It is important to detect circulating anti-GBM autoantibodies early for patients with RPGN in order to save time for appropriate therapy.

关 键 词：肾小球肾炎 肾小球基底膜 自身抗体 测定 

分 类 号：R692.310.4[医药卫生—泌尿科学]