血清IgA、C_3及IgA/C_3比值在IgA肾病诊断中的应用价值  

Clinical Diagnotic Value of Determination of Serum IgA,C_3 Levels and IgA/C_3 Ratio in Patients with IgA Nephropathy

作　　者：姚瑶[1] 蒋更如[1] 

机构地区：[1]上海交通大学医学院附属新华医院肾脏内科,200092

出　　处：《放射免疫学杂志》2010年第5期532-535,共4页Journal of Radioimmanology

摘　　要：目的:探讨原发性IgAN和非IgAN原发性肾小球肾炎患者血清IgA、C3水平和IgA/C3比值的差异及与病理Lee氏分级的相关性。方法:选择上海交通大学医学院附属新华医院肾脏内科经肾穿刺组织活检确诊为原发性IgAN患者167例与非IgAN原发性肾小球肾炎患者105例,以透射免疫比浊法测定其血清IgA和C3浓度,按Lee氏分级标准评估IgAN的病理分级。结果:①原发性IgAN患者与非IgAN原发性肾小球肾炎患者血清IgA水平分别为[(2.98±1.27)vs(2.15±0.88)g/L,P<0.01];血清C3水平分别为[(1.11±0.27)vs(1.12±0.29)g/L,P>0.05];IgA/C3比值分别为[(2.83±1.34)vs(2.05±1.12),P<0.01];②Lee氏分级为Ⅰ和Ⅱ级与Lee氏分级为Ⅲ、Ⅳ、Ⅴ级的IgAN患者血清IgA水平分别为[(2.73±0.95)vs(3.12±1.41)g/L,P<0.05];血清C3水平分别为[(1.94±0.32)vs(1.10±0.24)g/L,P>0.05];IgA/C3比值分别为[(2.70±1.45)vs(2.90±1.26),P>0.05]。③IgAN患者不同临床起病表现组间IgA、C3水平和IgA/C3比值的差异均无统计学意义。结论:血清IgA水平及IgA/C3比值可作为鉴别IgAN与非IgAN的参考指标,血清C3水平的降低程度与IgAN患者病理严重程度相关。Objective To study the difference of serum IgA,C3 levels and IgA/C3 ratio between the patients with primary IgA nephropathy （IgAN） and non-IgA nephropathy as well as the correlation of these parameters with Lee’s grading system in patients with IgA nephropathy.Methods Renal biopsy was performed in 167 patients with primary IgAN and 105 patients with non IgA primary glomerulonephritis.The levels of serum IgA,C3 were detected with turbidimetric method in all these patients.Results ①The levels of serum IgA in the patients with IgAN were significantly higher than those in patients with non-IgA nephropathy （2.98 ± 1.27 vs 2.15 ± 0.88g/L,P〈 0.01） ,but the serum C3 levels were not much different （1.11 ± 0.27 vs 1.12 ± 0.29g/L,P〈 0.05） .The IgA/C3 ratio IgAN group was also significantly higher than that in the non-IgA group （2.83 ± 1.34 vs 2.05 ± 1.12,P〈 0.01） .②The serum IgA levels of the patients of Lee I andⅡ pathologic grade were significantly lower than those in the patients with LeeⅢ,Ⅳ,Ⅴgrade （2.73 ±0.95 vs 3.12 ±1.41g/L,P〈 0.05） .The serum C3 levels （1.94 ±0.32 vs 1.10 ±0.24g/L,P〈 0.05） and IgA/C3 ratio （2.70 ±1.45 vs 2.90 ±1.26,P〈 0.05） were also analyzed.③The serum IgA,C3 levels and IgA/C3 ratio among IgA nephropathy patients with different clinical types of onset （e.g.hematuria or albuminuria） were not significantly different （P〈 0.05） .Conclusion The serum IgA level and IgA/C3 ratio could be used as a reference parameter for identifying IgAN from non-IgAN.The lowering of serum C3 level appeared to be closely related with severity of pathology in patients with IgAN.

关 键 词：血清IGA 血清C3 血清IgA/C3比值 IGAN 诊断价值 

分 类 号：R692.31[医药卫生—泌尿科学]