M型磷脂酶A2受体在原发性膜性肾病中的诊断价值及其血清抗体水平与预后的关系  

Diagnostic value of PLA2R for primary membranous nephropathy and the correlation between its serum antibody levels and prognosis

作　　者：徐倩 万峻宏 黄翠 吴卫红 XU Qian;WAN Junhong;HUANG Cui;WU Weihong(Department of Nephrology,Shangrao People's Hospital,Jiangxi Province,Shangrao334000,China)

机构地区：[1]江西省上饶市人民医院肾内科,江西上饶334000

出　　处：《中国当代医药》2024年第20期44-47,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202212745)。

摘　　要：目的探讨M型磷脂酶A2受体(PLA2R)对原发性膜性肾病(PMN)的诊断价值,及其血清抗体水平与疗效的相关性。方法选取上饶市人民医院2021年9月至2022年12月收治的80例PMN患者作为PMN组,另选取同时期收治的37例继发性膜性肾病(SMN)患者作为SMN组,检测两组患者肾组织中PLA2R的表达,比较组间差异。检测PMN患者的血清PLA2R抗体表达情况,分析阳性患者的血清PLA2R抗体水平随着治疗进行与24 h尿蛋白、血清白蛋白(Alb)、血肌酐(SCr)水平的相关性。结果PMN组的肾组织PLA2R阳性率高于SMN组,差异有统计学意义(P<0.05)。受试者特征曲线(ROC)分析显示,肾组织PLA2R表达诊断PMN的敏感度为81.25%、特异度为91.89%,ROC曲线下面积为0.866,具有较高的诊断效能。血清PLA2R抗体阳性的PMN患者的抗体水平与疗效的相关性分析显示,血清PLA2R抗体水平与24 h尿蛋白水平呈正相关(r=0.452),差异有统计学意义(P<0.05),与Alb水平呈负相关(r=-0.426),差异有统计学意义(P<0.05)。结论肾组织PLA2R的表达有助于PMN与SMN的鉴别诊断,血清PLA2R抗体水平的降低可提示治疗有效。Objective To investigate the diagnostic value of M-type phospholipase A2 receptor(PLA2R)in primary membranous nephropathy(PMN)and the correlation between serum antibody level and therapeutic effect.Methods A total of 80 patients with PMN admitted to the Shangrao People's Hospital from September 2021 to December 2022 were selected as the PMN group,and 37 patients with secondary membranous nephropathy(SMN)admitted during the same period were selected as the SMN group.The expression of PLA2R in renal tissues of the two groups were detected,and the differences between the groups were compared.Serum PLA2R antibody expression was detected in PMN patients,and the correlation between serum PLA2R antibody level and 24 h urinary protein,serum albumin(Alb)and serum creatinine(SCr)levels in positive patients with treatment were analyzed.Results The positive rate of PLA2R in kidney tissue in PMN group was higher than that in SMN group,and the difference was statistically significant(P<0.05).Receiver characteristic curve(ROC)analysis showed that the sensitivity and specificity of PLA2R expression in renal tissue in diagnosing PMN were 81.25% and 91.89%,and the area under ROC curve was 0.866,indicating high diagnostic efficacy.The correlation analysis between serum PLA2R antibody level and efficacy of PMN patients with positive serum PLA2R antibody showed that serum PLA2R antibody level was positively correlated with 24 h urinary protein level(r=0.452),and the difference was statistically significant(P<0.05),and was negatively correlated with Alb level(r=-0.426),and the difference was statistically significant(P<0.05).Conclusion The expression of PLA2R in kidney tissue is helpful for the differential diagnosis of PMN and SMN,and the decrease of serum PLA2R antibody level may indicate the effectiveness of treatment.

关 键 词：M型磷脂酶A2受体 M型磷脂酶A2受体抗体 原发性膜性肾病 继发性膜性肾病 

分 类 号：R692[医药卫生—泌尿科学]