血清抗磷脂酶A2受体抗体在膜性肾病诊断中的应用价值  

Application value of serum anti-phospholipase A2 receptor antibody in the diagnosis of membranous nephropathy

作　　者：王晞[1] 

机构地区：[1]云南省第二人民医院肾脏内科,云南昆明650000

出　　处：《中国医药导报》2018年第3期60-63,共4页China Medical Herald

摘　　要：目的探讨血清抗磷脂酶A2受体(PLA2R)抗体在膜性肾病诊断中的应用价值。方法选择2014年7月~2016年8月于云南省第二人民医院(以下简称"我院")肾内科进行治疗的膜性肾病患者50例作为观察组,选择我院体检科的50名健康体检者作为对照组,比较两组患者血清抗PLA2R抗体和多种生化免疫指标结果,分析指标之间的关系。结果观察组抗PLA2R抗体滴度高于对照组,TP、IgG低于对照组,差异有统计学意义(P<0.05);两组IgM、IgA、C3和C4比较差异无统计学意义(P>0.05)。抗PLA2R抗体对膜性肾病的诊断灵敏度为58.00%,特异度为98.00%,抗PLA2R抗体与TP、IgG和IgA呈负相关(r=-3.954、-0.483、-0.286,P<0.05),与C4呈正相关(r=0.256,P<0.05),与IgM和C3无相关性(P>0.05)。结论在临床上利用ELISA检测抗PLA2R抗体的技术正在成熟,通过抗PLA2R抗体检测进行膜性肾病的诊断是一个良好的研究方向,而且ELISA对于抗PLA2R抗体可以进行定量检测的属性,对于膜性肾病的病情变化监测和治疗效果的评估也有着辅助判断的作用。Objective To evaluate application value of serum anti-phospholipase A2 receptor antibody in the diagnosis of membranous nephropathy. Methods Fifty patients with membranous nephropathy treated with nephrology in Department of Nephrology, the Second People′s Hospital of Yunnan Province（ ＂our hospital＂ for short） from July 2014 to August 2016 were selected as observation group. Fifty healthy subjects of our hospital Physical Examination Department were selected as control group. Serum anti-phospholipase A2 receptor antibody and a variety of biochemical immune indicators of the results between two groups were compared, the relationship between indicators were analyzed. Results The anti-phospholipase A2 antibody titer in observation group was higher than that in control group, TP and IgG in observation group were lower than those in control group, the differences were statistically significant（P〈0.05）. There was no significant difference in IgM, IgA, C3 and C4 between two groups（P〈0.05）. The diagnostic sensitivity of anti-phospholipase A2 antibody to membranous nephropathy was 58.00%, specificity was 98.00%. There was a positive correlation between anti-phospholipase A2 antibody and TP, IgG and IgA（r =-3.954,-0.483,-0.286, P〈0.05）, and positively correlated with C4（r = 0.256, P〈0.05）, and Ig M and C3 did not show correlation（P〈0.05）. Conclusion The technique of detecting anti-phospholipase A2 antibody by ELISA is maturing. The diagnosis of membranous nephropathy by antiphospholipase A2 antibody detection is a good research direction, and ELISA can be used for quantitative detection of anti-phospholipase A2 antibody, and the change of condition for membranous nephropathy monitoring and treatment of the effectiveness of the assessment, but also has the role of auxiliary judgment.

关 键 词：血清抗磷脂酶A2受体抗体 膜性肾病 肾病综合征 

分 类 号：R692[医药卫生—泌尿科学]