原发性系膜增生性肾小球肾炎补体及免疫球蛋白水平分析  

Analysis of Complement and Immunoglobulin Levels in Patients with Primary Mesangial Proliferative Glomerulonephritis

作　　者：卜先辉[1] 王兴春 张娓娓 

机构地区：[1]安康职业技术学院附属医院肾病内科,陕西安康725000 [2]安康市中心医院肾病内科,陕西安康725000

出　　处：《临床误诊误治》2017年第10期90-93,共4页Clinical Misdiagnosis & Mistherapy

基　　金：陕西省科学技术研究发展计划项目(2013K14-02-12)

摘　　要：目的观察原发性系膜增生性肾小球肾炎(mesangialprolifera-tiveglomerulonephritis,Ms PGN)患者补体、免疫球蛋白水平的变化,寻找病情评估的可靠指标。方法选取我院2013年2月—2016年6月经肾活检确诊为原发性Ms PGN的90例患者,观察不同性别、不同年龄段、不同24 h尿蛋白定量水平患者血清Ig G、Ig E、Ig M、Ig A及补体C3、C4水平,以及补体、免疫球蛋白与24 h尿蛋白定量的相关性。结果 90例原发性Ms PGN血清Ig M阳性及Ig G阳性各79例(87.78%)。女性患者Ig G、Ig M水平较男性患者高,Ig E水平低于男性患者,差异均有统计学意义(P<0.05或P<0.01)。随患者年龄的增长,Ig A水平逐渐升高,Ig E水平逐渐降低,差异有统计学意义(P<0.05);Ig A在不同24 h尿蛋白定量组间差异有统计学意义,5.0~13.0 g/24 h组Ig A水平显著高于其他组(P<0.05),且血清Ig A水平与24 h尿蛋白定量呈正相关(r=0.227,P=0.031)。结论通过观察原发性Ms PGN患者补体、免疫球蛋白的变化可判断疾病的进展及调整治疗方案,并可经干预细胞免疫水平以改善患者预后。Objective To observe changes of complement and immunoglobulin levels in patients with primary me-sangial proliferative glomerulonephritis （ MsPGN） in order to look for reliable indicators for condition assessment. Methods A total of 90 patients with primary MsPGN, who were confirmed by renal biopsy examination during February 2013 and June 2016 were recruited in this study, and serum immunoglobulin G （ IgG） , IgE, IgM and IgA and complement C3 and C4 levels in patients with different genders, ages and 24 h urine protein quantitative levels were observed, and correlations between com-plement and immunoglobulin levels with 24 h urine protein quantitative levels. Results Among the 90 patients with primary MsPGN, serum positive IgM and IgG were 79 patients （87. 78%） respectively. In females, IgG and IGM levels were signifi-cantly higher, while IgE level was significantly lower than those in males （P〈0. 05 or P〈0. 01）. With the increasing age of patients, IgG levels were gradually increased, and IgE levels were gradually decreased （P〈0. 05）. Differences of IgA levels in patients with different 24 h urine protein quantitative levels groups were statistically significant （P〈0. 05）, and IgA level in patients with 5. 0-13. 0 g/24 h urine protein quantitative level was significantly higher than those in patients with other 24 h urine protein quantitative levels （ P〈0. 05 ） , and the serum IgA level was positively correlated with the 24 h urine protein quantitative level （r=0. 227, P=0. 031）. Conclusion Progress and adjustment treatment of the disease can be determined by observing changes of complement and immunoglobulin levels in patients with primary MsPGN, and cellular immunity level can be interfered in order to improve prognosis of patients.

关 键 词：肾小球肾炎 膜增生性 补体系统蛋白质类 免疫球蛋白类 

分 类 号：R692.31[医药卫生—泌尿科学]