抗磷脂酶A2受体抗体诊断鉴别特发性膜性肾病的临床价值  

Clinical Value of Anti-phospholipase A2 Receptor Antibody in the Differential Diagnosis of Idiopathic Membranous Nephropathy

作　　者：邵敏[1] SHAO Min(The First People's Hospital of Taicang City,Taicang,Jiangsu 215400,China)

机构地区：[1]江苏省太仓市第一人民医院,江苏太仓215400

出　　处：《大医生》2020年第12期18-20,共3页Doctor

摘　　要：目的探讨抗磷脂酶A2受体(PLA2R)抗体检测诊断特发性膜性肾病(IMN)的临床价值。方法选取2018年1月至2019年6月江苏省太仓市第一人民医院25例IMN患者为试验组,同期25例继发性膜性肾病(SMN)患者为对照1组,非膜性肾病的健康体检志愿者为对照2组。采集三组静脉血样检测PLA2R抗体,统计阳性率。基于金标准,评价PLA2R抗体诊断IMN的灵敏度与特异度。另比较试验组PLA2R抗体检测阳性与阴性患者的临床资料,分析其与患者疾病活动的关系。结果试验组血清PLA2R抗体检测阳性率(76.0%)高于对照1组(8.0%)和对照2组(0.0%),差异有统计学意义(P<0.05);基于金标准,血清抗磷脂酶A2受体抗体检测诊断IMN灵敏度76.0%、特异度96.0%,总符合率86.0%。试验组血清PLA2R抗体阳性患者24 h尿蛋白定量、血清ALB、NS占比与血清PLA2R抗体阴性患者,差异有统计学意义(P<0.05)。结论PLA2R抗体检测可以为IMN临床诊断和鉴别提供有价值的依据,在判断IMN病情方面也能提供一定参考,值得推广使用。Objective To investigate the clinical value of anti-phospholipase A2 receptor(PLA2R)antibody in the diagnosis of idiopathic membranous nephropathy(IMN).Methods From January 2018 to June 2019,25 patients with IMN in the First People's Hospital of Taicang City were selected as the experimental group,and 25 patients with secondary membranous nephropathy(SMN)in the same period were selected as the control 1 group.The healthy volunteers of non-membrane nephropathy were selected as the control 2 group.The venous blood samples of the 3 groups were collected and the anti-PLA2R antibodies were detected,the positive rates were also calculated.Based on gold standard,the sensitivity and specificity of anti-PLA2R antibody in the diagnosis of IMN were evaluated.Moreover,the clinical data of patients with positive and negative anti-PLA2R antibodies were compared to analyze its relationship with patient's disease activity.Results The positive rate of serum anti-PLA2R antibody in experimental group(76.0%)was higher than that in control 1 group(8.0%)and control 2 group(0.0%),the difference was statistically significant(P<0.05).Based on the gold standard,the sensitivity,specificity and total coincidence rate of serum anti-PLA2R antibody detection in the diagnosis of IMN were 76.0%,96.0%and 86.0%,respectively.There was significant differences in 24 h urine protein quantification,serum ALB level and NS ratio between patients with negative anti-PLA2R antibody and patients with positive anti-PLA2R antibody in the experimental group(all P<0.05).Conclusion Anti-PLA2R antibody detection can provide valuable basis for clinical diagnosis and differentiation of IMN,and can also provide some reference in judging the state of IMN,which is worth popularizing.

关 键 词：特发性膜性肾病 抗磷脂酶A2受体抗体 尿蛋白 

分 类 号：R69[医药卫生—泌尿科学]