血清PLA2R抗体与膜性肾病患者病情的相关性

Serum PLA2R antibody in diagnosis and disease evaluation of patients with membranous nephropathy

摘要:

目的  探讨血清磷脂酶A2受体（PLA2R）抗体与膜性肾病（MN）患者病情的相关性。方法  选取2013年5月-2015年2月河南省南阳市中心医院收治的膜性肾病患者193例，根据肾组织活检病理结果分为特发性膜性肾病（IMN组）和继发性膜性肾病（SMN组），选取同期到该院进行体检的健康者30例（对照组），比较3组受试者的血清白蛋白、血清总蛋白、24 h尿蛋白定量、血肌酐水平、PLA2R抗体浓度及阳性率。分析实验室指标与PLA2R抗体的相关性，并计算PLA2R抗体检测的特异性和阳性预测值。结果  IMN组和SMN组患者的血清白蛋白、血清总蛋白水平明显低于对照组（P <0.05），24 h尿蛋白定量、血肌酐明显高于对照组（P <
0.05）。IMN组和SMN组各项实验室指标的组间比较差异无统计学意义（P >0.05）。IMN组、SMN组、对照组患者的血清PLA2R抗体水平分别为（12.149±5.207）μg/ml、（8.492±3.218）μg/ml及（0.003±0.001）μg/ml，阳性率分别为68.99%、18.75%及0.00%，差异有统计学意义（P <0.05）。血清白蛋白水平与MN患者血清PLA2R抗体呈负相关（r =-0.625，P =0.023），24 h尿蛋白定量水平与MN患者血清PLA2R抗体呈正相关（r =0.796，P =
0.015）。ELISA法PLA2R抗体检测的特异度为96.67%，阳性预测值为99.01%。结论  血清PLA2R抗体水平与膜性肾病病情有明显相关性，其阳性表达与肾组织活检结果符合度较高。

关键词:

PLA2R抗体;膜性肾病;血清白蛋白

Abstract:

Objective To investigate the correlationship of serum phospholipase A2 receptor (PLA2R) antibody in diagnosis and disease evaluation of patients with membranous nephropathy. Methods 193 patients with membranous nephropathy from May 2013 to February 2015 were divided into three groups according to the results of renal biopsy, IMN group, secondary membranous nephropathy (SMN group), 30 healthy subjects as control group. Copare the indexes as followed: serum albumin, total serum protein, 24 h urinary protein, serum creatinine, PLA2R antibody concentration and its' positive rate. Correlation analysis laboratory indexes and PLA2R antibodies and calculate specificity and positive predictive value PLA2R antibody detection. Results The levels of serum albumin and serum total protein in IMN group and SMN group were significantly lower than those in control group (P < 0.05), 24 h urine protein, serum creatinine were significantly higher than those in control group (P < 0.05). The difference between the IMN group and the SMN group was not statistically significant (P > 0.05). The positive rates of serum PLA2R antibody levels in IMN group, SMN group and control group were (5.207 ± 12.149) g/ml, (3.218 ± 8.492) g/ml, (0.001 ± 0.003) g/ml, the positive rate was 68.99 %, 18.75 %, 0.00 % respectively, the difference was statistically significant (P < 0.05). Serum albumin level was significantly negatively correlated with serum PLA2R antibody in patients with MN (r = -0.625, P = 0.023), and serum PLA2R antibody was positively correlated with 24 h (r = 0.796, P = 0.015). The specificity of PLA2R antibody detection was 96.67 %, the positive predictive value was 99.01 %, and the positive predictive value was 99.01 %. Conclusions PLA2R serum antibody levels with membranous nephropathy disease has obvious relevance, its expression and renal biopsy results consistent with a higher degree.

Key words:

PLA2R antibody; membranous nephropathy; albumin