本文選題：特發(fā)性膜性腎病 + 磷酯酶A��； 參考：《廣東醫(yī)學(xué)》2017年12期

【摘要】：目的探討血清中M型磷脂酶A2受體(PLA2R)抗體的初始水平與特發(fā)性膜性腎病(IMN)患者免疫治療療效的相關(guān)性。方法選取79例經(jīng)腎活檢穿刺診斷為IMN的患者,根據(jù)治療前血清PLA2R抗體水平的不同將其分為高濃度組和低濃度組;采用足量糖皮質(zhì)激素聯(lián)合環(huán)磷酰胺治療12個(gè)月,分別檢測(cè)兩組患者治療前后的24 h尿蛋白定量、血清白蛋白、血肌酐、血總膽固醇及血尿酸的水平,每2個(gè)月重復(fù)檢測(cè),統(tǒng)計(jì)學(xué)分析治療前后兩組患者各項(xiàng)指標(biāo)的變化;治療結(jié)束后評(píng)價(jià)并比較兩組的治療效果。結(jié)果治療后PLA2R抗體低濃度組療效分布與高濃度組差異有統(tǒng)計(jì)學(xué)意義(P0.01);與治療前相比,兩組患者治療后24 h尿蛋白定量下降,血清白蛋白水平上升,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。治療過(guò)程中低濃度組24 h尿蛋白下降程度和時(shí)間及血清白蛋白上升程度和時(shí)間均優(yōu)于高濃度組,且差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 IMN患者治療前的血清PLA2R抗體的初始濃度與治療療效呈負(fù)相關(guān),對(duì)預(yù)測(cè)患者臨床緩解時(shí)間及緩解率具有一定的參考價(jià)值。
[Abstract]:Objective to investigate the relationship between the initial level of PLA2R antibody in serum and the immunotherapy efficacy of idiopathic membranous nephropathy (IMN). Methods Seventy-nine patients with IMN diagnosed by renal biopsy were divided into high concentration group and low concentration group according to the level of serum PLA2R antibody before treatment, and were treated with adequate glucocorticoid combined with cyclophosphamide for 12 months. The levels of 24 h urine protein, serum albumin, serum creatinine, serum total cholesterol and serum uric acid were measured before and after treatment. The therapeutic effects of the two groups were evaluated and compared after the treatment. Results there was a significant difference in the distribution of therapeutic effect between the low concentration group of PLA2R antibody and the high concentration group after treatment (P 0.01), compared with that before treatment, the urine protein quantity decreased and the serum albumin level increased in the two groups at 24 h after treatment, and the difference was statistically significant (P 0.05). During the course of treatment, the degree and time of 24 h urinary protein decrease and the increase of serum albumin in the low concentration group were better than those in the high concentration group, and the difference was statistically significant (P 0.05). Conclusion the initial concentration of serum PLA2R antibody in patients with IMN is negatively correlated with the therapeutic efficacy, and it has certain reference value in predicting the clinical remission time and remission rate.
【作者單位】： 河南省人民醫(yī)院腎病風(fēng)濕免疫科;
【分類(lèi)號(hào)】：R692

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