摘要
目的探讨血清抗磷脂酶A2受体(PLA2R)抗体及肾功能相关指标、病理活检指标对特发性膜性肾病(IMN)的临床诊断价值。方法选取2020年1月至2022年1月广州医科大学附属第二医院通过肾脏穿刺病理活检确诊的80例膜性肾病(MN)患者作为研究对象,包括62例IMN患者(IMN组)和18例其他MN患者(非-IMN组);另选取同期在该院体检的健康人群62例作为对照组。比较各组血清肾功能相关指标[血清胆固醇(CHOL)、肌酐(Cr)、甘油三酯(TG)、尿酸(UA)、总蛋白(TP)、清蛋白(ALB)]、免疫学指标[球蛋白(GLB)、免疫球蛋白(Ig)G、IgA、IgM]水平,并分析抗PLA2R抗体与病理活检指标间的关系。结果血清抗PLA2R抗体诊断IMN的特异度为72.2%,灵敏度为58.1%;IMN组中,肾组织临床病理分期诊断为Ⅰ期的患者血清抗PLA2R抗体阳性率为50.0%,Ⅱ期为63.6%,Ⅲ期为40.0%;IMN组血清CHOL、TG、UA水平均高于对照组,TP、ALB、GLB、IgG、IgA、IgM水平均低于对照组,差异均有统计学意义(P<0.05);非-IMN组TP、ALB、IgG水平低于对照组,UA、Cr水平高于对照组,差异均有统计学意义(P<0.05);IMN组中抗PLA2R抗体阳性患者TP、IgG水平低于抗PLA2R抗体阴性患者(P<0.05)。结论血清抗PLA2R抗体联合肾功能和免疫学指标及病理活检指标对IMN的诊断及评估肾脏损伤程度有一定临床诊断价值。
Objective To explore the clinical diagnostic value of serum anti-phospholipase A2 receptor(PLA2R)antibody,renal function indexes and pathological biopsy indexes in idiopathic membranous nephropathy(IMN).Methods A total of 80 patients with membranous nephropathy(MN)diagnosed by renal biopsy in the Second Affiliated Hospital of Guangzhou Medical University from January 2020 to January 2022 were selected as the research objects including 62 patients with IMN(IMN group)and 18 patients with other MN(non-IMN group),meanwhile 62 healthy people who underwent physical examination in the Second Affiliated Hospital were selected as the control group.The levels of renal function indexes[serum CHOL,Cr,TG,UA,TP,ALB]and immunological indexes[GLB,IgG,IgA,IgM]relationship between serum anti-PLA2R antibody between the two groups,the relationship between serum anti-PLA2R antibody and pathological biopsy index was analyzed.Results The specificity and sensitivity of serum anti-PLA2R antibody in the diagnosis of IMN were 72.2%and 58.1%,respectively.In the IMN group,the serum anti-PLA2R antibody positive rate was 50.0%in patients diagnosed with stageⅠ,63.6%in patients diagnosed with stageⅡ,and 40.0%with stageⅢ.The levels of serum CHOL,TG and UA in the IMN group were higher than those in the control group,but the levels of TP,ALB,GLB,IgG,IgA and IgM were lower than those in the control group,and the differences had statistical significance(P<0.05).The levels of TP,IgG and ALB in th non-IMN group were lower than those in the control group,but the levels of UA and Cr were higher than those in the control group,and the differences were statistically significant(P<0.05).In the IMN group,the levels of TP and IgG in patients with positive anti-PLA2R antibody were lower than those in patients with negative anti-PLA2R antibody(P<0.05).Conclusion Serum anti-PLA2R antibody combined with renal function,immunological indexes and pathological biopsy indexes are of certain value in the diagnosis of IMN and the evaluation of the degree of renal injury.
作者
李志方
陈荣彬
林烨欣
魏洁
LI Zhifang;CHEN Rongbin;LIN Yexin;WEI Jie(Department of Clinical Laboratory,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510260,China;KingMed School of Laboratory Medicine,Guangzhou Medical University,Guangzhou,Guangdong 510182,China)
出处
《检验医学与临床》
CAS
2023年第21期3183-3186,共4页
Laboratory Medicine and Clinic
关键词
特发性膜性肾病
抗PLA2R抗体
肾功能指标
病理活检
idiopathic membranous nephropathy
anti-phospholipase A2 receptor antibody
renal function index
pathological biopsy
作者简介
李志方,女,副主任技师,主要从事医学免疫学方向的研究;通信作者:魏洁,E-mail:weijiegyey@163.com。
