两种方法检测血清抗磷脂酶A2受体抗体在膜性肾病中的应用分析  

The application of two methods of detecting serum anti-phospholipase A2 receptor antibodies in patients with membranous nephropathy

作　　者：方玲[1] 顾向明[1] 周泽红[1] 林淼雄 齐晓云[1] FANG Ling GU XiangmingA ZHOU Zehong LIN Miaoxiong QI Xiaoyun(Department of Clinical Laboratory, Zhongshan Chinese Medicine Hospital Affiliated of Guangzhou Chinese Medicine University, Zhongshan, Guangdong 528400, Chin)

机构地区：[1]广州中医药大学附属中山中医院检验科,广东中山528400

出　　处：《检验医学与临床》2017年第15期2196-2198,共3页Laboratory Medicine and Clinic

基　　金：广东省中山市科学技术基金资助项目(2015B1214)

摘　　要：目的探讨酶联免疫吸附试验(ELISA)和间接免疫荧光法(IIF)检测血清抗磷脂酶A2受体抗体(抗PLA2R抗体)在膜性肾病(MN)中的阳性率,分析两种方法在MN的诊断效能,为临床MN的诊治提供特异度更高的实验指标。方法选取该院肾内科就诊行肾病理活检并确诊的MN患者31例,对照组50例包括该院住院自身免疫性疾病及肾病综合征、肾功能不全患者38例及健康体检者共12例,收集血清同时进行以上两种方法检测,分析两种方法在MN中的诊断效能,并分析其对MN的诊断一致性。结果 MN组中,ELISA法及IIF法检测结果均为阳性17例,两种方法分别显示阳性和阴性各1例,两种方法同时阴性12例,两种方法检测阳性率为58.06%(18/31);对照组50例均为阴性,阳性率为0.00%(0/50)。两种方法检测抗PLA2R抗体阳性率在MN组和对照组间比较,差异有统计学意义(χ~2=37.32,P<0.05)。两种方法诊断MN的灵敏度、特异度、阳性预测值、阴性预测值、准确率指标依次为58.06%(18/31),100.00%(50/50),100.00%(18/18),79.37%(50/63),83.95%(68/81);两种方法单独检验与联合检验对MN的诊断性能比较,差异均无统计学意义(P>0.05)。ELISA法在MN组及对照组中抗PLA2R抗体水平分别为45.42(2.00,760.40)及2.00(2.00,3.21)RU/mL,两组间抗体水平比较,差异有统计学意义(Z=-5.345,P<0.05)。结论 ELISA法及IIF法检测血清抗PLA2R抗体在MN诊断中具有较高的特异度与准确率,可作为MN诊断,尤其是特发性MN及无法行肾活检患者的必要和特异性血清学检测指标。Objective To investigate the positive rates of enzyme-linked immunosorbent assay （ELISA） and indirect immunoflu- orescence （IIF） in detecting serum anti-phospholipase A2 receptor antibodies （anti-PLA2R antibodies） in membranous nephropathy （MN） and to analyze the performance of the two methods in the diagnosis of MN. Methods A total of 31 cases of MN patients confirmed by kidney biopsy were identified as MN group. Another 38 patients with non-MN kidney diseases and 12 healthy persons at the same period were selected as the control group. The serum anti-PLA2R antibodies was tested and detected by the two meth- ods. The performance and consistency of the two kinds of method were analyzed. Results ELISA and the IIF showed 17 cases with positive anti-PLA2R antibodies coincidently,and the two methods showed the results of one case with anti-PLA2R antibodies and one case without negative anti-PLA2R antibodies, respectively. And the two methods showed 12 cases without anti-PLA2R antibod- ies coincidently. The results showed that 50 cases of the control group were all negative. The positive rates of two methods in the MN group were both 58. 06% （18/31） ,which was significantly higher than that of the control group （x^2 =37.32 ,P〈0.05）. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy rates of the two methods were 58.06 % （18/ 31） ,100.00%（50/50） ,100.00%（18/18） ,79.37%（50/63） and 83.95%（68/81）. The single detection of the two methods and com- bined detection for MN diagnosis had no statistical significance （P〉0.05）. The level of anti-PLA2R antibodies measured by ELISA in MN group and control group were 45.42 （2.00,760.40） and 2.00 （2.00,3.21 ） RU/mL, the difference was statistically significant （Z= -5. 345,P〉0.05）. Conclusion ELISA and the IIF in detecting the serum anti-PLA2R antibodies in MN has high specificity and accuracy in the diagnosis. Anti-PLA2R antibodies can be a specific serological detection inde

关 键 词：肾小球肾炎 膜性肾病 抗磷脂酶A2受体抗体 酶联免疫吸附试验 间接免疫荧光法 

分 类 号：R996.3[医药卫生—毒理学]