抗Vinculin足细胞自身抗体在儿童特发性肾病综合征中的表达及临床意义

Expression of Anti-Vinculin podocyte autoantibody in children with idiopathic nephrotic syndrome and its clinical significance

目的探讨血清抗Vinculin足细胞自身抗体在儿童特发性肾病综合征(INS)中的表达阳性率,及对INS诊断、预后的价值。方法采用ELISA方法检测80例INS患儿及320例健康儿童血清Vinculin-IgG抗体水平,根据抗体滴度水平将80例INS患儿分为抗体阳性组和阴性组,并对不同组病例的临床资料进行分析。结果与健康儿童相比较,INS患儿抗Vinculin抗体阳性率显著升高(30/80 vs 10/320,P<0.05),抗体阳性率与患儿激素敏感性无关(24/63 vs 6/13,P>0.05)。与抗体阴性INS患儿相比较,抗体阳性INS患儿24 h尿蛋白定量水平升高[(3200.7±1286.8)mg/24 h vs(1051.2±266.3)mg/24 h,P<0.05]。抗体阳性患儿组血清抗Vinculin抗体滴度与INS患儿24 h尿蛋白定量存在相关性(r=0.586,P<0.05),尿蛋白转阴后,抗体滴度较确诊时明显下降(P<0.05)。结论血清抗Vinculin足细胞抗体在INS早期诊断、疗效评估、预后判断中可能具有重要的临床意义。

Objective To explore the positive rate of serum anti-Vinculin podocyte autoantibody in children with idiopathic nephrotic syndrome(INS)and its clinical value in the diagnosis and prognosis.Methods SerumVinculin-IgG antibody levels in 80 children with INS and 320 healthy children were detected by ELISA,and the serum anti-Vinculin antibody titers in children with INS and healthy children were compared.Eighty children with INS were divided into antibody positive group and negative group according to the antibody titer,and clinical data of different groups of patients were analyzed.Results Compared with healthy children,the positive rate of anti-Vinculin antibody in INS children was significantly higher(30/8010/320,P<0.05),and the positive rate of antibody was not related to the hormone sensitivity(24/636/13,P>0.05).Compared with INS children with antibody negative,INS children with antibody-positive had higher 24-hour urine protein quantitation[(3200.7±1286.8)(1051.2±266.3),P<0.05].There was a correlation between the serum anti-Vinculin antibody titer and the 24-hour urine protein content of the INS children with antibody-positive(=0.586,P<0.05).After the urine protein turned negative,the antibody titer decreased significantly(P<0.05).Conclusions Serum anti-vinculin podocyte antibody may have an important clinical significance in the early diagnosis,efficacy evaluation and prognosis estimation of INS.