血清抗M型磷脂酶A_2受体抗体在特发性膜性肾病中的表达及意义

Expression and significance of serum anti-M phospholipase A_2 receptor antibody in idiopathic membranous nephropathy

目的探讨特发性膜性肾病(idiopathic membranous nephropathy,IMN)血清抗M型磷脂酶A_2受体(M-type phospholipase A_2receptor,PLA_2R)抗体的表达及其在IMN诊断中的价值。方法经肾活检组织病理证实IMN患者70例为IMN组,周期体检健康者20例为对照组。采用ELISA法检测2组血清抗PLA_2R抗体水平,分析IMN患者血清抗PLA_2R抗体水平与血清白蛋白、24h尿蛋白相关性。结果 IMN组血清抗PLA_2R抗体阳性51例(72.85%),对照组均为阴性(0);IMN组血清抗PLA_2R抗体水平[40.5(3.1,764.3)RU/mL]明显高于对照组[5.9(2.1,11.2)RU/mL](P<0.05);IMN患者血清抗PLA_2R抗体水平与24h尿蛋白呈正相关(r=0.541,P=0.000),与血清白蛋白呈负相关(r=-0.387,P=0.004)。结论IMN患者血清抗PLA_2R抗体表达阳性率高,抗PLA_2R抗体可能是IMN的特异性抗体,可用于IMN的诊断和病情评估。

Objective To analyze the expression of serum anti-M phosphotipase A2 receptor （PLA2R） antibody in patients with idiopathic membranous nephropathy （IMN） and to evaluate its significance. Methods The serum anti-PLA2 R level was detected in 70 patients with IMN confirmed by renal biopsy （IMN group） and 20 healthy volunteers （control group） by ELISA method, and the correlation of anti-PLAzR with serum albumin and 24-hour urinary protein was analyzed. Results Serum anti-PLA2R antibody was positive in 51 patients （72.85%） in IMN group and negative in all patients in eontrol group. The level of serum anti-PLA2R IMN antibody was 40.5 （3.1, 764.3） RU/mL in IMN group, significantly higher than that in control group （5. 9 （2. 1, 11. 2） RU/mL） （P〈0.05）. The serum level of anti-PLA2R antibody was positively correlated with urinary protein （r= 0. 541, P=0. 000） and negatively correlated with serum albumin （r=0. 387, P= 0. 004）. Conclusion The positive rate of serum anti-PLA2 R antibody is high in IMN patients, suggesting serum PLA2 R antibody might be a specific antibody of IMN, and can be used for the diagnosis and prediction of IMN.