急性肾炎患儿血清抗钠泵α1亚基抗体的检测  

Study on the detection of serum Na pump α1 submit autoantibody in pediatric patients with acute glomerulonephritis

作　　者：冯东霞[1] 宋文琪[1] 王艳[1] 李爱华[1] 

机构地区：[1]首都医科大学附属北京儿童医院检验中心,北京100045

出　　处：《临床和实验医学杂志》2015年第20期1719-1722,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的检测急性肾小管肾炎患者血清抗钠泵α1亚基抗体的水平,并评价其对钠泵功能的影响。方法急性肾小球肾炎患儿195例,并对其中33例建立随访,分别于疾病期间及疾病痊愈后3个月和6个月检测血清抗钠泵α1亚基抗体的水平。同时使用受试者血清作用HEK-293A细胞膜蛋白后检测钠泵活性。结果急性肾小球肾炎患者血清抗钠泵α1亚基抗体水平较对照组显著升高(P<0.05),女性显著高于男性(P<0.05),且主要表现为IgM类抗体升高。3个月后血清IgM抗钠泵α1亚基抗体水平较患病时显著下降(P<0.05),但IgG抗钠泵α1亚基抗体水平较患病时显著升高(P<0.05)。6个月后IgM抗体平均降至表面健康对照组水平,但IgG类抗体水平仍高于对照组(P<0.05)。细胞实验结果表明,IgG类抗钠泵α1亚基能显著抑制人肾脏细胞系HEK-293A细胞的钠泵活性(P<0.05),但IgM类抗体无上述作用(P>0.05)。结论急性肾小球肾炎患者血清中可存在钠泵α1亚基自身抗体。IgG类钠泵α1亚基自身抗体能抑制钠泵的活性,这可能是导致急性肾小球肾炎慢性长期肾损伤的机制之一。Objective To detect the serum Na pump α1 submit autoantibody in pediatric patients with acute glomerulonephritis and to evaluate its effect on activity of Na pump. Methods A total of 195 pediatric patients with acute glomerulonephritis were enrolled in this study. Among them,33 cases had established follow- up during thecourse of illness and three months to six months after recovery of the disease. Results The serum level of Na pump α1 subunit antibody in patients with acute glomerulonephritis was significantly higher than that of control group（ P〈0. 05）,the percentage of affection in girls were significantly higher than that of boys（ P〈0. 05）,and it mainlypresented in IgM class antibodies. Serum Na pump α1 IgM antibody was significantly decreased in 3 months after onset of the disease（ P〈0. 05）,but serum level of IgG antibody was significantly increased than that of controls（ P〈0. 05）. Serum level of Na pump α1 IgG antibody was significantly higher than that of controls after 6 months（ P〈0. 05） and serum level of IgM antibody was similar to that of controls. IgG Na pump α1 subunit antibody could significantly inhibit the activity of Na pump in HEK- 293 A cells（ P〈0. 05）,but IgM antibody had no such effect（ P〉0. 05）. Conclusion Na pump α1 subunit autoantibodies can be detected in pediatric patients with acute glomerulonephritis. IgG Na pump α1 subunit autoantibody can inhibit the activity of Na pump,and it may play animportant role in long- term renal impairment in patients with acute glomerulonephritis.

关 键 词：急性肾小球肾炎 钠泵 自身抗体 

分 类 号：R726.9[医药卫生—儿科]