尿Ⅳ型胶原及血清磷脂酶A2受体抗体在膜性肾病中的临床应用价值  

Roles of urinary type Ⅳ collagen and serum phospholipase A2 receptor antibody in membranous nephropathy

作　　者：王蕾[1] 黄鹤 徐旻一 周芳芳 卢培[1] 黄秋芳[1] 熊仲波 卫晓青 戴悦[1] WANG Lei;HUANG He;XU Minyi;ZHOU Fangfang;LU Pei;HUANG Qiufang;XIONG Zhongbo;WEI Xiaoqing;DAI Yue(Department of Clinical Laboratory,Shanghai Eighth People's Hospital,Xuhui Branch of Shanghai Sixth People's Hospital,Shanghai 200235,China;Department of Clinical Microbiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]上海市第八人民医院上海市第六人民医院徐汇分院检验科,上海200235 [2]复旦大学附属中山医院临床微生物科,上海200032

出　　处：《检验医学》2019年第8期726-729,共4页Laboratory Medicine

基　　金：上海申康医院发展中心专项基金资助(SHDC22014010)

摘　　要：目的探讨尿Ⅳ型胶原(ⅣC)及磷脂酶A2受体(PLA2R)抗体在膜性肾病(MN)中的临床价值。方法采用磁微粒化学发光法分别检测73例MN患者(MN组)、42例系膜增殖性肾小球肾炎(MsPGN)患者(MsPGN组)及50名体检健康者(正常对照组)尿ⅣC水平,采用酶联免疫吸附试验(ELISA)定量检测其中57例MN患者及14例MsPGN患者血清PLA2R抗体水平。采用Spearman相关分析评估血清PLA2R抗体与尿ⅣC、尿微量白蛋白(mAlb)的相关性。结果MN组和MsPGN组尿ⅣC水平明显高于正常对照组(P<0.01),而MN组与MsPGN组之间差异无统计学意义(P>0.05)。57例MN患者中有30例血清PLA2R抗体阳性,阳性率为52.6%;14例MsPGN患者PLA2R抗体均为阴性。在MN患者中,PLA2R抗体阳性者尿ⅣC水平明显高于PLA2R抗体阴性者(P<0.01),尿mAlb水平差异无统计学意义(P>0.05)。血清PLA2R抗体水平与尿ⅣC水平呈正相关(r=0.370,P<0.01),与尿mAlb水平无相关性(r=0.027,P>0.05)。结论尿ⅣC及血清PLA2R抗体在MN的诊断中有重要价值,且血清PLA2R抗体可用于特发性MN与继发性MN的鉴别诊断。Objective To investigate the roles of urinary typeⅣcollagen(ⅣC)and serum phospholipase A2 receptor(PLA2R)antibody in membranous nephropathy(MN).Methods A total of 73 patients with MN,42 patients with mesangial proliferative glomerulonephritis(MsPGN)and 50 healthy subjects were enrolled,and urinaryⅣC level was determined by magnetic particle chemiluminescence.Serum PLA2R antibody level of 57 cases of MN and 14 cases of MsPGN were determined by enzyme-linked immunosorbent assay(ELISA).The correlation between serum PLA2R antibody level and urinary microalbumin(mAlb)level was analyzed.Results UrinaryⅣC levels in MN and MsPGN groups were higher than that in healthy control group(P<0.01),while the difference between MN and MsPGN groups was not statistically significant(P>0.05).In the 57 cases of MN,30 cases were positive for PLA2R antibody,and the positive rate was 52.6%,while 14 cases of MsPGN were all negative.The level of urinaryⅣC in the PLA2R antibody positive group of MN patients was higher than that in the PLA2R antibody negative group(P<0.01).There was no statistical significance for urinary mAlb level between the 2 groups(P>0.05).PLA2R antibody level was positively correlated with urinaryⅣC level(r=0.370,P<0.01),while there was no correlation with urinary mAlb level(r=0.027,P>0.05).Conclusions UrinaryⅣC and serum PLA2R antibody can be used in the diagnosis,treatment and prognosis monitoring of MN,and serum PLA2R antibody has clinical value in the differential diagnosis of idiopathic and secondary MN.

关 键 词：Ⅳ型胶原 磷脂酶A2受体抗体 膜性肾病 系膜增殖性肾小球肾炎 

分 类 号：R446.1[医药卫生—诊断学]