血清PLA2R抗体与尿液IgG4在特发性膜性肾病患者中的检测价值研究

Detection value of serum PLA2R antibody and urine IgG4 in patients with idiopathic membranous nephropathy

目的:探索血清PLA2R抗体与尿液IgG4在特发性膜性肾病患者中的检测价值.方法:选取2018年1月~2019年8月于我院接受治疗的84例膜性肾病患者为研究对象,按照患者的病理分型将患者分为两组, 48例特发性膜性肾病的患者为特发性膜性肾病组, 36例继发性膜性肾病患者为继发性膜性肾病组,另选取32例同期于我院接受体检的健康患者为对照水平,比较缓解组和非缓解组患者血清抗磷脂酶A2受体抗体阳性率和尿IgG4.结果:特发性膜性肾病组患者的血清抗磷脂酶A2受体抗体阳性率为83.33%和尿IgG4水平(0.79±0.12) g/L显著高于继发性膜性肾病组以及对照组患者(P<0.05).继发性膜性肾病组患者的尿IgG4水平(0.54±0.11)g/L显著高于对照组患者(0.16±0.08)g/L (P<0.05).缓解组血清抗磷脂酶A2受体抗体阳性检出率为4.88%显著低于非缓解组患者为100.00%,数据具有统计学意义(P<0.05).治疗后缓解组患者的尿IgG4水平(0.23±0.05)g/L显著低于非缓解组患者(0.92±0.16) g/L (P<0.05).结论:特发性膜性肾病患者的血清抗磷脂酶A2受体抗体阳性检出率和尿液IgG4水平是影响患者预后情况的关键因素,二者联合检测有助于临床医务人员诊断特发性膜性肾病,尽早采取治疗措施,促进患者康复,具有重要预测价值.

Objective:To explore the value of serum PLA2K antibody and urine IgG4 in patients with idiopathic membranous nephropathy.Methods:84 patients with membranous nephropathy who were treated in our hospital from January 2018 to August 2019 were enrolled.The patients were divided into two groups according to their pathological classification.48 patients with idiopathic membranous nephropathy were included.In the idiopathic membranous nephropathy group,36 patients with secondary membranous nephropathy were in the secondary membranous nephropathy group,and 32 healthy patients who underwent physical examination in our hospital at the same time were used as control level,comparative relief group and non-remission group.The patient's serum anti-phospholipidase A2 receptor antibody positive rate and urine IgG4 were compared.Results:The serum anti-phospholipase A2 receptor antibody positive rate in patients with idiopathic membra nous nephropathy was 83.33%and urinary IgG4 level(0.79±0.12)g/L was significantly higher than that in the secondary membranous nephropathy group and the control group(P<0.05).The level of urinary IgG4(0.54±0.11)g/L in patients with secondary membranous nephropathy was significantly higher than that in the control group(0.16±0.08)g/L(P<0.05).The positive detection rate of serum antiphospholipidase A2 receptor antibody in the remission group was 4.88%,which was significantly lower than that in the non-remission group,and the negative detection rate of semni antiphospholipid A2 receptor antibody was 95.12%,which was significantly higher than that in the non-remission group.The patient was0.00%and the data were statistically significant(P<0.05).The urinary IgG4 level(0.23±0.05)g/L in the remission group was significantly lower than that in the non-remission group(0.92±0.16)g/L(P<0.05).Conclusion:Semm anti-phospholipase A2 receptor antibody positive rate and urine IgG4 level in patients with hemorrhagic membranous nephropathy are the key factors affecting the prognosis of patients.The combined detection is helpful in clinical diagnosis of idiopathic membrane.In osteopathic disease,taking early treatment measures to promote the rehabilitation of patients is valuable.