血清抗PLA2R抗体与膜性肾病患者临床特征及病理特点的关系

Relationship between serum anti-PLA2R antibody and clinical features and pathological features of patients with membranous nephropathy

目的分析血清抗磷脂酶A2受体(PLA2R)抗体与膜性肾病患者临床特征及病理特点的关系。方法选取2018年1月至2021年1月收治的100例膜性肾病患者作为研究对象,分析其临床资料、化验检验指标、病理检验资料、免疫组化指标。根据抗PLA2R抗体检测结果将患者分为抗PLA2R抗体阳性组(n=74)和抗PLA2R抗体阴性组(n=26)。比较两组的各检测指标。结果抗PLA2R抗体阳性组的肾病综合征、水肿发生率、TC水平、24 h尿蛋白定量、肾小球局灶性硬化总发生率均高于抗PLA2R抗体阴性组,ALB水平低于抗PLA2R抗体阴性组(P<0.05)。特发性膜性肾病组的抗PLA2R抗体、IgG4表达强度高于继发性膜性肾病组(P<0.05)。结论抗PLA2R抗体阳性者更易出现肾病综合征、水肿等情况,且其TC水平、24 h尿蛋白定量、肾小球局灶性硬化发生率更高,对于特发性膜性肾病患者,其抗PLA2R抗体、IgG4表达强度更高。

Objective To analyze the relationship between serum anti-phospholipase A2 receptor(PLA2R)antibody and clinical features and pathological features of patients with membranous nephropathy.Methods A total of 100 patients with membranous nephropathy treated from January 2018 to January 2021 were selected as the research objects,and their clinical data,laboratory test indexes,pathological test data and immunohistochemical indexes were analyzed.According to the anti-PLA2R antibody test results,the patients were divided into anti-PLA2R antibody positive group(n=74)and anti-PLA2R antibody negative group(n=26).The detection indexes of the two groups were compared.Results The incidences of nephrotic syndrome and edema,TC level,24 h urinary protein quantification,the total incidence of glomerular focal sclerosis in the anti-PLA2R antibody positive group were higher than those in the anti-PLA2R antibody negative group,the ALB level was lower than that in the anti-PLA2R antibody negative group(P<0.05).The expression intensity of anti-PLA2R antibody and IgG4 in the idiopathic membranous nephropathy group were higher than those in the secondary membranous nephropathy group(P<0.05).Conclusion The patients with anti-PLA2R antibody positive are more likely to have nephrotic syndrome and edema,and their TC level,24 h urinary protein quantification and the incidence of glomerular focal sclerosis are higher.For patients with idiopathic membranous nephropathy,the expression intensity of anti-PLA2R antibody and IgG4 is higher.