【摘要】 目的探讨血清抗M型磷脂酶A2受体(PLA2R)抗体成人不典型膜性肾病(ua MN)中的诊断价值及其与蛋白尿水平相关性。方法收集北京大学深圳医院肾内科2010年1月至2015年2月住院的100例MN患者临床资料,100例MN包括特发性MN(i MN)41例,病因不明的ua MN 22例,乙型肝炎病毒相关性膜性肾病(HBV-MN)18例和膜性狼疮性肾炎(LN-MN)19例;另选取34例非MN患者作为对照。酶联免疫吸附试验(ELISA)检测血清抗PLA2R抗体滴度,并与24 h尿蛋白量、血肌酐进行相关性分析。结果 34例非MN组患者血清抗PLA2R抗体均阴性;仅1例(5.3%)LN-MN阳性;i MN组、ua MN组、HBV-MN组血清抗PLA2R抗体阳性率分别为58.5%、68.2%和72.2%,i MN组与ua MN组患者血清抗PLA2R抗体滴度与24 h尿蛋白定量呈线性相关(P<0.05)。结论血清抗PLA2R抗体阳性ua MN患者可归类于i MN,该抗体滴度可预测i MN蛋白尿变化。更多还原

【Abstract】 Objective To investigate the diagnostic value of anti-PLA2 R antibody in atypical membranous nephropathy and its relationship with proteinuria level. Methods Serum of 100 patients with membranous nephropathy were collected in this study, including 41 cases of i MN, 22 cases of ua MN, 18 cases of HBV-MN and 19 cases of lupus nephritis MN; another 34 cases of non-MN nephrophathy were chosen as the control. ELISA was used to detect serum anti-PLA2 R antibody, and Spearman correlation was detected to investigate the correlation of anti-PLA2 R titers with 24-hour urine protein and serum creatinine respectively. Results There were no positive cases in non-MN nephropathy group, and only 1 LN-MN case was positive(positive rate 5.3%). There was positive rate of 58.5% in i MN group, and 68.2% in ua MN group, as well as 72.2% in HBV-MN group. Within i MN group and ua MN group, anti-PLA2 R titers were obviously correlated with 24-hour urine protein(P <0.05). Conclusion The ua MN patients with pasitive anti-PLA2 R antibody can be classified into i MN population and the level of anti-PLA2 R in ua MN patients can predict the changes of proteinuria in i MN.更多还原