特发性膜性肾病患者血清抗PLA2R抗体表达与免疫治疗效果的关系研究  

Expression of serum anti-phospolipase A2 receptor antibodies in patients with idiopathic membranous nephropathy and its relationship with the effect of immunotherapy

作　　者：徐亚沛[1] 任蕾[2] 孙晓芳[3] 邹燕[1] 崔东锋[1] 吴宪鸣[1] 

机构地区：[1]郑州市第三人民医院肾内科,河南郑州450000 [2]郑州大学第一附属医院内分泌科,河南郑州450002 [3]河南省人民医院检验科,河南郑州450000

出　　处：《河南医学研究》2017年第12期2119-2122,共4页Henan Medical Research

摘　　要：目的检测特发性膜性肾病(idiopathic membranous nephropathy,IMN)患者血清抗磷脂酶A2受体(PLA2R)抗体的表达,探讨血清抗PLA2R抗体的表达与免疫抑制治疗效果的关系。方法回顾性分析2012年1月至2016年1月于郑州市第三人民医院肾内科住院的患者,经肾活检诊断为IMN患者50例,检测血清抗PLA2R抗体表达,给予小剂量环孢素A(CsA)联合小剂量泼尼松治疗,观察血清抗PLA2R抗体表达及其与免疫抑制治疗的关系。结果 50例IMN患者中血清抗PLA2R抗体阳性组37例,占74%。治疗6个月时,抗PLA2R抗体阴性组24 h尿蛋白定量和血清白蛋白缓解情况明显优于抗PLA2R抗体阳性组(P<0.05),累计缓解率为84.7%,抗PLA2R抗体阳性组累计缓解率为45.9%。结论血清抗PLA2R抗体的检测可用于协助诊断IMN,采用小剂量Cs A联合小剂量泼尼松治疗抗PLA2R抗体阴性患者效果优于抗PLA2R抗体阳性患者。Objective To detect the expression of serum anti - phospolipase A2 receptor （PLA2R） antibodies in patients with idiopathic membranous nephropathy （IMN）, and to discuss the relationship between serum anti -PLA2R antibodies and the effect of immunotherapy. Methods A total of 50 patients who were diagnosed as IMN from January of 2012 to January of 2016 in the Department of Nephrology of the Third People＇ s Hospital of Zhengzhou were included in this study. The expression of serum anti - PLA2R antibodies was detected by indirect immunofluorescence assay. The IMN paients were treated with low - dose cyclosporine （CsA） and low - dose prednisone and the relationship between serum anti - PLA2R antibody and the effect of immunotherapy was observed. Resets The ratio of anti - PLA2R antibody positive IMN was 74% （37/50）. The recovery conditions in proteinuria and serum albumin were better in the serum anti - PLA2R antibody negative IMN group since 6 months after the treatment （P 〈 0. 05 ）. The overall response rate in serum anti - PLA2R antibody negative IMN group was 84.7% after treatment for 6 months. However, the overall response rate in serum anti - PLA2R antibodies positive IMN group reached 45.9%. Conclusions Detection of serum anti - PLA2R antibodies can be helpful to diagnose IMN. Serum anti - PLA2R antibody negative IMN patients have a better effect of immunotherapy.

关 键 词：特发性膜性肾病 抗磷脂酶A2受体抗体 免疫治疗 

分 类 号：R692[医药卫生—泌尿科学]