血清IgA-纤维连接蛋白聚合物在IgA肾病诊断中的意义

DIAGNOSTIC VALUE OF SERUM IGA FIBRONECTIN AGGREGATES TO IGA NEPHROPATHY

为探讨血清ＩｇＡ－纤维连接蛋白（ＦＮ）聚合物在ＩｇＡ肾病中的辅助诊断价值，对９１例ＩｇＡ肾病、１４例过敏性紫癜性肾炎、１１７例非ＩｇＡ肾脏病、２４例非肾脏病及２３４例健康人采用ＥＬＩＳＡ方法检测了血清中ＩｇＡ－ＦＮ聚合物水平。结果显示，ＩｇＡ肾病血清该聚合物水平及阳性率（６１．５％）显著高于狼疮性肾炎（３０．８％）、其他非ＩｇＡ肾脏病（８．８％）、非肾脏病（０．０％）及健康人群（５．１％）（Ｐ＜０．０５），但与过敏性紫癜性肾炎组（４２．９％）差异无显著性（Ｐ＞０．０５）。提示该聚合物对ＩｇＡ肾病具有一定的辅助诊断价值。但因在过敏性紫癜性肾炎及狼疮性肾炎时也有较高的阳性率，应注意鉴别。

In order to demonstrate the diagnostic value of serum IgA fibronectin (FN) aggregates in IgA nephropathy, serum samples from 91 patients with IgA nephropathy, 14 patients with Henoch Schonlein purpura, 117 patients with non IgA nephritis, 24 random in patients and 234 normal controls were examined for IgA FN aggregates by using ELISA. The results showed that the level of IgA FN aggregates increased markedly in the serum of patients with IgA nephropathy and 61.5% of them reached the positive standard. Only 8.8% of the patients with non IgA nephritis, none of the in patients with non renal diseases and 5.1% of the normal controls were beyond the positive criteria. But the level of IgA FN aggregates were also elevated in the serum of patients with Henoch Schonlein purpura and lupus nephritis. These data indicate that serum IgA FN aggregates may be useful in the diagnosis of IgA nephropathy, but Henoch Schonlein purpura and lupus nephritis should be ruled out.