本文選題：特發(fā)性膜性腎病 + 乙型肝炎病毒相關(guān)性膜性腎病��； 參考：《重慶醫(yī)學(xué)》2017年18期

【摘要】：目的探討腎組織M型磷脂酶A2受體1(PLA2R1)抗原及其抗體在膜性腎病(MN)患者中的表達(dá)水平。方法選取經(jīng)腎活檢證實(shí)的特發(fā)性MN(IMN)58例、乙型肝炎病毒相關(guān)性MN(HBV-MN)15例、V型狼瘡性腎炎(V-LN)17例。采用間接免疫熒光法檢測(cè)腎組織PLA2R1抗原,并與IgG4共定位。同時(shí)檢測(cè)上述MN患者血清抗PLA2R1抗體。分析腎組織PLA2R1抗原及其抗體在MN中的表達(dá)差異,以及PLA2R1陽(yáng)性與陰性患者臨床資料的差異。結(jié)果 V-LN及HBV-MN患者腎組織及血清中均未發(fā)現(xiàn)PLA2R1抗體;在81.03%IMN患者腎組織檢測(cè)到PLA2R1抗原,70.69%IMN患者血清中檢測(cè)到PLA2R1抗體,PLA2R1抗原與IgG4共定位,均沿腎小球毛細(xì)血管袢呈細(xì)顆粒狀沉積。PLA2R1抗原陽(yáng)性患者24h尿蛋白定量高于陰性患者(P0.05),并且血清清蛋白低于陰性患者(P0.05)。結(jié)論腎組織PLA2R1抗原在IMN的診斷中敏感性及特異性均較高,且表達(dá)與臨床病情嚴(yán)重性明顯相關(guān)。
[Abstract]:Objective to investigate the expression of type M phospholipase A 2 receptor 1 (PLA 2 R 1) antigen and its antibody in patients with membranous nephropathy (MN). Methods 58 cases of Idiopathic MNNMN, 15 cases of HBV associated MNV and 17 cases of V type lupus nephritis confirmed by renal biopsy were selected. PLA 2 R 1 antigen was detected by indirect immunofluorescence assay and co-located with IgG 4. At the same time, the serum anti-PLA 2 R 1 antibody was detected in the above MN patients. To analyze the difference of expression of PLA2R1 antigen and antibody in MN and the clinical data of PLA2R1 positive and negative patients. Results PLA2R1 antibody was not found in renal tissue and serum of patients with V-LN and HBV-MN, PLA2R1 antigen was detected in renal tissue of 81.03IMN patients and PLA2R1 antibody was detected in IMN patients' serum. The 24-hour urinary protein quantity in the patients with positive antigen of PLA2R1 was higher than that in the negative patients (P 0.05), and the serum albumin was lower than that in the negative patients (P 0.05). Conclusion the sensitivity and specificity of renal PLA2R1 antigen in the diagnosis of IMN are high, and the expression of PLA2R1 antigen is significantly related to the severity of the clinical condition.
【作者單位】： 南方醫(yī)科大學(xué)附屬南海醫(yī)院腎內(nèi)科;南方醫(yī)科大學(xué)附屬南海醫(yī)院檢驗(yàn)科;南方醫(yī)科大學(xué)附屬南海醫(yī)院病理科;
【基金】：佛山市衛(wèi)生和計(jì)劃生育委員會(huì)醫(yī)學(xué)科研課題(20160213)
【分類號(hào)】：R692

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