血清PLA2R抗体为导向的膜性肾病的病情及预后评估

Assessment of the condition and prognosis of serum PLA2R antibody-directed membranous nephropathy

[目的]探讨血清抗M型磷脂酶A2受体(PLA2R)抗体对膜性肾病的病情及预后价值。[方法]选取蚌埠医学院第一附属医院2017年1月至2018年12月收治的153例膜性肾病(MN)患者作为研究对象,根据患者疾病类型对患者进行分组:143例原发性膜性肾病(PMN)与10例继发性膜性肾病(SMN)。选取同期到该院接受健康体检的30例志愿者作为对照组,对比3组受试者各项实验室指标水平。将PMN患者分为PLA2R抗体低水平组、高水平组与阴性组,对患者进行为期1 a的随访,记录各组患者疾病预后情况。[结果]PMN、SMN组患者血肌酐、24 h尿蛋白定量、PLA2R抗体水平均明显高于健康对照组(P<0.05);随访1 a发现,疾病完全缓解患者主要分布在PLA2R抗体阴性组,疾病进展患者主要分布在PLA2R抗体低水平组与高水平组(P<0.05)。[结论]膜性肾病患者血肌酐、24 h尿蛋白定量及PLA2R抗体较健康志愿者明显升高,PLA2R抗体是影响患者疾病进展与完全缓解的一项危险因素,抗体水平越高,患者疾病预后效果越差。

[Objective]To explore the value of serum anti-M-phospholipase A2 receptor(PLA2 R)antibody in the condition and prognosis of membranous nephropathy.[Methods]153 patients with membranous nephropathy(MN)admitted in first affiliated hospital of Bengbu Medital college from January 2017 to December 2018 were selected as the subjects of this study.According to the types of disease,the patients were divided into 143 patients with primary membranous nephropathy(PMN)and 10 patients with secondary membranous nephropathy(SMN).30 volunteers who received physical examination in the hospital in the same period were selected as the control group to compare the laboratory indicators of the three groups.PMN patients were divided into PLA2 R antibody low level group,high level group and negative group.[Results]the levels of serum creatinine,24 hour urine protein and pla2 r antibody in PMN and SMN groups were significantly higher than those in healthy control group(P<0.05).[Conclusion]Serum creatinine,24 hour urine protein and pla2 r antibody in patients with membranous nephropathy is significantly higher than healthy volunteers.PLA2 R antibody is a risk factor for disease progression and complete remission.The higher the antibody level,the worse the prognosis of patients.