血清磷脂酶A2受体抗体与膜性肾病临床和病理的相关性  

The correlation between Serum phospholipase A2 receptor antibody and clinicopathological features in patients with membranous nephropathy

作　　者：黄其鹏[1,2] 徐高四 王芳[1] 曾芳 方卫东 HUANG Qi-peng;XU Gao-si;FANG Fang;ZENG Fang;FANG Wei-dong(Ganzhou People＇s Hospital,Ganzhou,Jiangxi 341000;The Second Affiliated Hospital of Nanchang university,Nanchang,Jiangxi 330000)

机构地区：[1]赣州市人民医院,江西赣州341000 [2]南昌大学第二附属医院,江西南昌330000

出　　处：《赣南医学院学报》2018年第7期646-650,共5页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的:探讨特发性膜性肾病(IMN)患者血清磷脂酶A2受体(PLA2R)抗体与血清临床生化指标以及病理分期之间的关联。方法:选取2016年1月至2018年1月肾穿刺活检的患者,同时随机选取健康体检者,分为IMN组和非IMN组,IMN患者根据病理分期结果分为Ⅰ期、Ⅱ期、Ⅲ期三组,用软件进行统计分析。结果:总共入选患者357例,其中IMN患者155例,非膜性肾病组患者183例,健康对照组19例;IMN组平均年龄高于非膜性肾病组(P=0.01),Ⅲ期膜性肾病组年龄、胱抑素c、血肌酐均高于Ⅰ期膜性肾病、Ⅱ期膜性肾病两组(P分别为0.003、0.000和0.000),Ⅱ期膜性肾病、Ⅲ期膜性肾病两组的血清PLA2R抗体滴度水平高于Ⅰ期膜性肾病组(P=0.006);血清抗PLA2R抗体与血清白蛋白呈负相关(rs=-0.234,P=0.003),IMN组患者血清PLA2R抗体滴度水平显著高于非膜性肾病患者(P<0.001)。结论:IMN患者血清PLA2R抗体基线滴度水平与血清白蛋白呈负相关,Ⅰ期IMN患者血清PLA2R抗体滴度水平显著低于Ⅱ期和Ⅲ期IMN患者。Objective： To assess the correlation between Serum phospholipase A2 receptor antibody and clinicopathological features in patients with membranous nephropathy. Method： The patients being hospitalized for renal biopsy were selected in this study from January 2016 to January 2018. and normal controls were randomly selected,all the patients were divided into idiopathic membranous nephropathy and Non-idiopathic membranous nephropathy groups,patients with idiopathic membranous nephropathy were divided into stageⅠ,Ⅱ and Ⅲ three groups,using software for statistical analysis.Results： A total of 357 patients were enrolled,including 155 patients with idiopathic membranous nephropathy,183 patients with Non-idiopathic membranous nephropathy,and 19 cases for normal controls. the average Age of Idiopathic membranous nephropathy（ IMN） group is higher than membranous nephropathy group（ P = 0. 01）,different pathological stages of idiopathic membranous nephropathy general clinical characteristics analysis results showed that the Age,cys c,serum creatinine（ Scr） in stage Ⅲ membranous nephropathy group were higher than stage Ⅰ and Ⅱ membranous nephropathy（ P values were 0. 003,0. 000 and 0. 000 respectively）; titers of serum phospholipase A2 receptors antibody with stageⅡ and Ⅲ membranous nephropathy higher than stageⅠ membranous nephropathy group（ P = 0. 006）; Serum albumin levels correlated inversely with serum anti-PLA2 R antibody titers（ rs=-0. 234,P = 0. 003）,Serum antiphospholipase A2 receptor（ PLA2 R） antibody titer level in patients with idiopathic membranous nephropathy was significantly higher than that in patients with non-membranous nephropathy（ P〈0. 001）. Conclusion： Baseline titer of serum anti-PLA2 R antibody is negatively correlated with serum albumin in the IMN patients,and serum anti-PLA2 R antibody level in patients with stage Ⅰ IMN was significantly lower than stage Ⅱ and Ⅲ IMN patients.

关 键 词：抗磷脂酶A2受体抗体 膜性肾病 临床病理 

分 类 号：R692.3[医药卫生—泌尿科学]