非GPS肾小球疾病患儿抗GBM抗体的检测及与临床表现相关性研究

DETECTION AND RELATIONSHIP TO CLINICAL OF ANTIGBM ANTIBODY IN CHILDREN WITH NON GOODPASTURE SYNDROME VARIABLE GLOMERULAR DISEASES

用免疫荧光法检测了４５例非ＧＰＳ肾小球疾病患儿血清中ＩｇＧ型抗ＧＢＭ抗体，阳性１３例占２８％。两组在尿蛋白和血清ＢＵＮ定量等无明显差异。但对３０例（１０例阳性，２０例阴性）患儿随访３年表明，阳性组复发率和死亡率均高于阴性组（ｔ＝３．３８，χ２＝３．９，Ｐ均小于０．０５）。阳性组抗ＧＢＭ抗体滴度与肾受损程度和复发率呈正相关（ｒ分别为０．５６，０．８６）。提示部分非ＧＰＳ肾小球疾病与自身免疫有关。

The sera of 45 children with variable glomerulonephritis were tested by immunofluorescence for present nonGoodpasture antiGBM antibody(AGBMAB)IgG.28%(13/45)had positive AGBMAB.AGBMAB weren′t found in the control subjects.There wasn′t evident distinguish in content of proteinuria/24 h and BUN in the serum between positive group and negative.10 children with positive AGBMAB and 20 children with negative were followed up to three years,positive group were higher recurrent rate and death rate than negative(t=3.38,χ2=3.9,P<005).The titer of AGBMAB had positive correlation with injured degree of kidney and recurrent rate(r respectively were 0.56,0.86).The results suggested that some nonGPS glomerular diseases were associated with autoimmunization.