摘要
目的探讨抗磷脂酶A2受体(PLA2R)抗体检测在特发性膜性肾病(IMN)中的,临床意义。方法选择2016年1月至12月期间行肾活检并确诊的IMN患者38例,继发性膜性肾病(SMN)患者46例,以同期体检中心志愿者30例作为对照,采用定量检测血清中抗PLA2R抗体并加以分析。结果与对照组比较发现,IMN组中抗PLA2R抗体水平显著升高,差异有统计学意义(P〈0.05);SMN组中抗PLA2R抗体水平稍微升高,差异无统计意义(P〉0.05)。与SMN组比较,IMN组中抗PLA2R抗体水平显著升高,差异有统计学意义(t=4.937,P〈0.05)。抗PLA2R抗体的敏感度为68.4%,特异度为93.5%,阳性预测值为89.7%,阴性预测值为78.2%。在病理Ⅰ、Ⅱ、Ⅲ分期中检出率分别是38.5%(5/13),83.3%(15/18),85.7%(6/7)。结论PLA2R抗体在IMN中较高的敏感度和特异度,可作为实验室诊断指标之一,可用于IMN与SMN之间鉴别。
Objective To investigate the clinical significance of antibody of anti-phosphase A2 receptor ( PLA2R ) amibody in idiopathic membranous nephropathy ( IMN ) . Methods From January 2016 to December 2016, there were 38 cases of IMN diagnosed at the first people's hospital in Hangzhou, 46 cases were secondary membranous nephropathy ( SMN ) , they were compared to 30 volunteers at the same time.The anti- PLA2R antibody in serum was analyzed by the quantitative. Results Compared with the control group, the anti- PLA2R antibody level of IMN group was significantly higher, and the difference was statistically significant ( P〈0.05 ) .The anti-PLA2R antibody levels in the SMN group were slightly elevated, the difference was not statistically significant ( P〉0.05 ) . In the IMN group, the anti- PLA2R antibody levels were significantly higher in the IMN group than the SMN group, and the difference was statistically significant ( P〈0.05 ) . The sensitivity of the anti-PLA2R antibody was 68.4%, the specificity was 93.5%, the positive predictive value was 89.7%, the negative predictive value was 78.2%. In pathological I , II, Ill stage, the detection rates were 38.5% ( 5/13 ) , 83.3% ( 15/18 ) , 85.7% ( 6/7 ) , respectively. Conclusion The high sensitivity and specificity of the PLA2R antibody in IMN can be used as a laboratory diagnostic indicator, which can be used to identify between IMN and SMN.
出处
《浙江临床医学》
2017年第12期2324-2325,共2页
Zhejiang Clinical Medical Journal