维吾尔族特发性膜性肾病患者血清抗PLA2R抗体表达的观察

Differences in serum anti-PLA2R antibody determination in Uygur patients with idiopathic membranous nephropathy in Xinjiang

目的检测维吾尔族特发性膜性肾病(IMN)患者中血清抗PLA2R抗体测定的灵敏度及特异度,了解维吾尔族IMN患者中血清抗PLA2R抗体能否作为一项生物学标记物。方法收集2016年11月至2017年5月新疆维吾尔自治区人民医院肾病科经肾活检明确诊断为IMN的维吾尔族患者29例作为IMN组,以及维吾尔族非IMN患者(包括IgA肾病,微小病变,局灶阶段肾小球硬化,系膜增生性肾小球肾炎等)29例作为非IMN组,抽取入院第2天晨起空腹血,行血清抗PLA2R抗体检测,收集基线资料、实验临床资料及数据,绘制ROC曲线。结果 IMN组血清抗PLA2R抗体阳性率为58.62%(17例),非IMN组中阳性率为0,在维吾尔族IMN患者中血清抗PLA2R抗体灵敏度为58.62%,特异度为100%,95%置信区间为[95%CI 69.8～93.9],阳性预测值100%,阴性预测值70.73%。符合率为79.31%。结论血清抗PLA2R抗体可作为检测维吾尔族IMN的生物学标志物,维吾尔族IMN患者中抗PLA2R抗体灵敏度及特异度与其它民族可能存在差异。

Objective To detect the sensitivity and specificity of anti-PLA2 R antibodies in Uygur patient with idiopathic membranous nephropathy（IMN）,understand whether the serum anti-PLA2 R antibody can be regarded as the biomarker in Uygur patients with IMN,then study whether there are differences in the expression of anti-PLA2 R antibody between Uygurs and other nationalities.Methods The clinic data of 29 IMN patients（test group）and 29 non-IMN patients（control group）in Uygurfrom November 2016 to May 2017 were collected.IMN was diagnosed by renal puncture biopsy.In the control group,there was IgA nephropathy,minimal lesion,focal periodic glomerular sclerosis and mesangial proliferative glomerulonephritis.The fasting blood in the morning was taken out on the second day after admission.The serum antiPLA2 R antibody was detected.Clinical data were estimated by ROC curve.Results The positive rate of anti-PLA2 R antibody in the test group was 58.62%（n=17/29）,and that in the control group was 0.The sensitivity and specificity of serum anti-PLA2 R antibody in Uygur patients with IMN were 58.62% and 100%,95% confidence was[68.9-93.9],the positive predictive value was 100%,negative predictive value was 70.73%,and the coincidence was 79.31%.Conclusions The serum anti-PLA2 R antibody can be regarded as the biomarker in Uygur patients with IMN.The sensitivity and specificity of serum anti-PLA2 R antibody in Uygur patients with IMN may differ from those in other nationalities.