IIFT法检测血清抗-PLA_2R抗体诊断特发性膜性肾病的效应  

Detection of serum anti-PLA_2R antibody by indirect immunofluorescence testing assay in idiopathic membranous nephropathy

作　　者：姚丽莉[1,2] 陈孝倩[1] 黄朝兴[1] YAO Lili;CHEN Xiaoqian;HUANG Zhaoxing(Division of Nephrology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China;Division of Nephrology, the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China)

机构地区：[1]温州医科大学附属第一医院肾内科,浙江温州325015 [2]温州医科大学附属第五医院肾内科,浙江丽水323000

出　　处：《温州医科大学学报》2019年第3期222-225,共4页Journal of Wenzhou Medical University

摘　　要：目的:探讨间接免疫荧光试验(IIFT)法检测血清抗-PLA2R抗体对诊断特发性膜性肾病(IMN)的敏感性和特异性。方法:收集2016年1月至2017年7月间在温州医科大学附属第一医院肾内科经肾活检诊断的104例肾小球疾病患者,其中成人IMN 80例、拟诊的继发性膜性肾病(SMN)7例和其他病理类型17例。抽取清晨空腹血样,按照血清抗-PLA2R抗体的检测方法分IIFT法组和ELISA法组,2组分别设部分SMN和其他病理类型病例作为对照。结果:IIFT法检测血清抗-PLA2R抗体40例,其中33例IMN血清抗-PLA2R抗体阳性26例,灵敏度为78.8%;2例SMN均阴性;5例其他病理类型中仅1例狼疮性肾炎IV型可疑阳性,其余4例阴性;IIFT法的特异度为85.7%(6/7)。ELISA法检测血清抗-PLA2R抗体64例,其中47例IMN患者中37例血清抗-PLA2R抗体阳性,灵敏度为78.7%;在5例SMN中,慢性乙型病毒性肝炎合并不典型膜性肾病1例和结肠癌合并IMN 1例阳性,另外3例阴性;12例非膜性肾病均阴性;ELISA法的特异度为94.1%(16/17)。结论:在成人IMN的诊断价值上,IIFT法检测血清抗-PLA2R抗体的敏感性和特异性与ELISA法基本相同。Objective:To investigate the sensitivity and specificity of indirect immunofluorescence testing (IIFT) assay for detecting serum anti-PLA2R antibody in patients with idiopathic membranous nephropathy (IMN). Methods:From January 2016 to July 2017, 104 patients with glomerular diseases were enrolled in this study of whom 80 were IMN, 7 secondary membranous nephropathy (SMN) and 17 other pathological types. After signing the informed consent, fasting blood samples were taken in the morning. According to the detection method of serum anti-PLA2R antibody, the patients were divided into IIFT method group and ELISA method group, and some SMN and other pathological type cases were set as control group. Results:Anti-PLA2R antibod-ies were detected by IIFT in 40 cases, of which 26 were positive for anti-PLA2R antibodies in 33 cases of IMN, with a sensitivity of 78.8%;2 cases were negative for SMN;only 1 case was suspicious positive for type IV of lupus nephritis in 5 other pathological types, and the other 4 cases were negative;the specificity of IIFT was 85.7%(6/7). Serum anti-PLA2R antibodies were detected by ELISA in 64 cases, of which 37 were positive in 47 cases of IMN, with a sensitivity of 78.7%. Among 5 cases of SMN, 1 case of chronic hepatitis B complicated with atypical membranous nephropathy and 1 case of colon cancer complicated with idiopathic membranous nephropathy were positive and 3 cases were negative;12 cases of non-membranous nephropathy were negative. The specificity of ELISA was 94.1%(16/17). Conclusion:The sensitivity and specificity of IIFT in detecting serum anti-PLA2R antibody are basically the same as ELISA in diagnosing adult IMN.

关 键 词：特发性膜性肾病 磷脂酶A2受体 抗-磷脂酶A2受体抗体 间接免疫荧光试验 

分 类 号：R392.3[医药卫生—免疫学]