發(fā)布時(shí)間：2018-04-04 20:24

  本文選題：腎小球腎炎　切入點(diǎn)：膜性　出處：《中國(guó)老年學(xué)雜志》2017年14期

【摘要】：目的探討血清抗M型磷脂酶A2受體(PLA2R)抗體與特發(fā)性膜性腎病(IMN)的臨床表現(xiàn)、病理改變及治療反應(yīng)等的關(guān)系。方法選取經(jīng)活檢明確診斷為IMN患者56例,應(yīng)用酶聯(lián)免疫吸附法(ELISA)檢測(cè)其血清抗M型PLA2R抗體,根據(jù)檢測(cè)結(jié)果將患者分為抗PLA2R抗體陽(yáng)性組和陰性組,回顧性分析兩組臨床和病理資料特點(diǎn)及對(duì)免疫抑制治療的反應(yīng)。結(jié)果 56例IMN患者中抗PLA2R抗體陽(yáng)性率為71.43%;陽(yáng)性組血清白蛋白水平低于陰性組、24 h尿蛋白水平高于陰性組(P0.05)。陽(yáng)性組中腎病綜合征(NS)患者的比例高于陰性組(P0.05)。陽(yáng)性組腎組織Ig G1亞型熒光強(qiáng)度≥嘌患者比例低于陰性組(P=0.015);Ig G4亞型熒光強(qiáng)度≥嘁患者比例高于陰性組(P=0.022);PLA2R陽(yáng)性表達(dá)者比例高于陰性組(P=0.015)。結(jié)論血清抗PLA2R抗體在IMN患者中陽(yáng)性率較高,有助于協(xié)助IMN疾病的診斷。抗體陽(yáng)性的IMN患者更易表現(xiàn)為NS,并與IMN的病情相關(guān)。血清抗PLA2R抗體陽(yáng)性患者腎組織更多地表現(xiàn)為Ig G4亞型的強(qiáng)陽(yáng)性沉積及PLA2R的陽(yáng)性表達(dá)。但基線抗PLA2R抗體與IMN患者對(duì)免疫抑制治療的反應(yīng)無(wú)關(guān)。
[Abstract]:Objective to investigate the relationship between serum anti type phospholipase A 2 receptor (PLA 2 R) antibody and idiopathic membranous nephropathy (IMN) in patients with idiopathic membranous nephropathy (IMN).Methods 56 patients with IMN diagnosed by biopsy were selected and their serum anti-M PLA2R antibodies were detected by Elisa. According to the results, the patients were divided into two groups: positive group and negative group.The clinical and pathological features of the two groups and their responses to immunosuppressive therapy were analyzed retrospectively.Results the positive rate of anti PLA2R antibody was 71.43 in 56 patients with IMN, and the serum albumin level in positive group was lower than that in negative group after 24 h urine protein level was higher than that in negative group.The proportion of patients with NSN in positive group was higher than that in negative group (P 0.05).Conclusion the positive rate of anti-PLA2R antibody in IMN patients is higher, which is helpful for the diagnosis of IMN disease.IMN patients with positive antibodies were more likely to present NSs and were associated with IMN.The strong positive deposition of IgG4 subtype and the positive expression of PLA2R in the renal tissue of the patients with anti PLA2R antibody positive were observed.But baseline anti-PLA2R antibodies were not associated with the response of IMN patients to immunosuppressive therapy.
【作者單位】： 吉林大學(xué)中日聯(lián)誼醫(yī)院腎內(nèi)科;吉林大學(xué)中日聯(lián)誼醫(yī)院血液科;
【基金】：國(guó)家自然科學(xué)基金面上項(xiàng)目(81370810) 吉林省科技廳自然科學(xué)基金項(xiàng)目(20160101059JC)
【分類號(hào)】：R692

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本文編號(hào)：1711545