本文選題：特發(fā)性膜性腎病 + PLA2R-Abs　； 參考：《河北醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:檢測(cè)特發(fā)性膜性腎病患者血清抗PLA2R抗體(PLA2R-Abs)及幽門螺桿菌感染情況,探討幽門螺桿菌感染與特發(fā)性膜性腎病血清抗PLA2R抗體和臨床指標(biāo)的關(guān)系。方法:1選取2014年1月至2016年6月于邢臺(tái)市人民醫(yī)院腎臟內(nèi)科住院經(jīng)腎臟病理診斷為特發(fā)性膜性腎病患者60例,記錄入選患者的一般資料。2實(shí)驗(yàn)分組1)根據(jù)IMN患者蛋白尿定量程度分為輕危(尿蛋白4.0g/d)組,中危(尿蛋白4-6g/d)和高危(尿蛋白6.0g/d)組。2)根據(jù)血清抗體檢測(cè)結(jié)果分為PLA2R-Abs陽性組和PLA2R-Abs陰性組。3)根據(jù)14C呼氣試驗(yàn)結(jié)果分為HP感染組和無HP感染組。3血清PLA2R-Abs的檢測(cè)采用雙抗體兩步夾心酶聯(lián)免疫吸附法(ELISA);使用14C呼氣實(shí)驗(yàn)檢測(cè)幽門螺桿菌感染情況。4統(tǒng)計(jì)分析:應(yīng)用SPSS軟件對(duì)用Microsoft Excel建立的資料庫(kù)的數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)處理。結(jié)果:1血清PLA2R-Abs的陽性例數(shù)48例,陽性率80%。IMN患者PLA2R-Abs陽性組血清白蛋白較PLA2R-Abs陰性組顯著降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05),尿蛋白定量、膽固醇、肌酐較陰性組顯著升高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2 M型血清PLA2抗體大于0.1ug/ml的患者48例,陽性率80%。高危組患者血清PLA2R-Abs濃度顯著高于中危組和輕危組(P0.05)。血清白蛋白隨著蛋白尿程度的增加進(jìn)行性減低(P0.05);血膽固醇和甘油三脂水平隨著蛋白尿程度的增加逐漸升高(P0.05);高危組患者血肌酐顯著高于中危組(P0.05)。3 HP陽性結(jié)果有43例,總感染率為71.7%。HP陽性組與陰性組比較血肌酐水平、尿蛋白定量顯著升高,差異有統(tǒng)計(jì)學(xué)意義(P0.05);陽性組血清白蛋白較陰性組顯著降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。4 HP陽性組與HP陰性組比較,血清PLA2R陽性率顯著升高,血清PLA2R水平明顯高于HP陰性組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。5 PLA2R-Abs與各個(gè)變量進(jìn)行直線相關(guān)分析,提示抗PLA2抗體與尿蛋白定量、血清肌酐呈顯著正相關(guān),與血清白蛋白呈顯著負(fù)相關(guān)(P0.05)。HP感染與各個(gè)變量進(jìn)行直線分析,提示HP感染與尿蛋白定量、血清肌酐呈顯著正相關(guān),與血清白蛋白呈顯著負(fù)相關(guān)(P0.05)。結(jié)論:1血清PLA2R-Abs是診斷IMN的無創(chuàng)特異性生物學(xué)指標(biāo),且與IMN病情密切相關(guān)。其特異度和敏感度均較高,且PLA2R抗體滴度對(duì)疾病活動(dòng)、病情緩解和復(fù)發(fā)有預(yù)測(cè)價(jià)值。2 IMN患者常伴隨HP感染存在,HP感染與血清PLA2R-Abs和尿蛋白、血清白蛋白、血肌酐存在相關(guān)性。
[Abstract]:Objective: to detect the serum anti PLA2R antibody (PLA2R-Abs) and Helicobacter pylori infection in patients with idiopathic membranous nephropathy, and to explore the relationship between Helicobacter pylori infection and serum anti PLA2R antibody and clinical indexes of idiopathic membranous nephropathy. Methods 1 from January 2014 to June 2016 in the nephrology department of Xingtai People's Hospital. 60 cases of idiopathic membranous nephropathy were broken, and the general data of the selected patients were recorded in the.2 experiment group 1) according to the degree of proteinuria in IMN patients, they were divided into light risk (urine protein 4.0g/d) group, middle risk (urine protein 4-6g/d) and high risk (urine protein 6.0g/d) group.2) according to serum anti physical examination results into PLA2R-Abs positive group and PLA2R-Abs negative group.3) according to 14C. The results of exhalation test were divided into HP infection group and non HP infection group,.3 serum PLA2R-Abs was detected by double antibody two step sandwich enzyme-linked immunosorbent assay (ELISA); 14C breath test was used to detect Helicobacter pylori infection in.4 statistical analysis: the data of the database established with Microsoft Excel was statistically processed with SPSS software. Results: 1 The number of positive cases of serum PLA2R-Abs in 48 cases, the positive rate of 80%.IMN patients with PLA2R-Abs positive group was significantly lower than that of the PLA2R-Abs negative group, the difference was statistically significant (P0.05), the urine protein quantitative, cholesterol, creatinine was significantly higher than the negative group, the difference was statistically significant (P0.05) the.2 M serum PLA2 antibody was greater than the 0.1ug/ml of the 48 patients, The serum PLA2R-Abs concentration in the positive rate 80%. group was significantly higher than that in the middle risk group and the light risk group (P0.05). The serum albumin was decreased with the increase of the proteinuria (P0.05); the level of blood cholesterol and glycerol three fat increased with the increase of proteinuria (P0.05); the serum creatinine of the high-risk group was significantly higher than that of the middle risk group (P0.05).3 HP The positive results were 43 cases, the total infection rate was 71.7%.HP positive group and the negative group compared with the serum creatinine level, the urine protein quantitative significantly increased, the difference was statistically significant (P0.05), the positive group serum albumin was significantly lower than the negative group, the difference was statistically significant (P0.05).4 HP positive group compared with HP negative group, serum PLA2R positive rate increased significantly. The level of PLA2R was significantly higher than that of HP negative group, the difference was statistically significant (P0.05).5 PLA2R-Abs was correlated with each variable, suggesting that anti PLA2 antibody and urine protein quantitative, serum creatinine was positively correlated, and serum albumin was negatively correlated with serum albumin (P0.05).HP infection and linear analysis of each variable, suggesting HP infection and urine egg. There was a significant positive correlation between serum creatinine and serum creatinine (P0.05). Conclusion: 1 serum PLA2R-Abs is a noninvasive biological index for diagnosis of IMN, and is closely related to the condition of IMN. Its specificity and sensitivity are high, and the PLA2R antibody titer has a predictive value of.2 IMN for disease activity, disease remission and recurrence. HP infection is often associated with HP infection, which is associated with serum PLA2R-Abs and urine protein, serum albumin and serum creatinine.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R692

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