PLA2R和IgG4对老年原发性膜性肾病的诊断价值

发布时间：2018-06-07 08:33

本文选题：膜性肾病 + PLAR　；参考：《解放军医学杂志》2017年09期

【摘要】：目的评估M型磷脂酶A2受体(PLA2R)和Ig G4对老年原发性膜性肾病(IMN)的诊断价值。方法纳入2014年4月-2016年2月在郑州大学第一附属医院肾内科进行肾活检的IMN(n=98)和非膜性肾病(Non-IMN,n=98)患者进行回顾性分析。男106例,女90例,年龄66.9±6.0岁。其中,IMN组男49例,女49例,年龄66.6±5.4岁;Non-IMN组男57例,女41例,年龄67.1±6.5岁。应用SPSS 13.0软件计算血清抗PLA2R抗体、肾小球PLA2R和Ig G1-4亚类诊断IMN的敏感度、特异度和ROC曲线下面积(AUC)。结果通过计算ROC曲线得到如下结果:血清抗PL A2R抗体诊断IMN的敏感度和特异度分别为77.6%和89.8%[AUC=0.869(0.816~0.923)];肾小球PLA2R诊断IMN的敏感度和特异度分别为66.3%和94.9%[AUC=0.805(0.741~0.870)];肾小球Ig G1-4诊断IMN的敏感度和特异度分别为80.6%、60.2%、41.8%、93.9%和78.6%、83.7%、84.7%、89.8%[AUC分别为0.767(0.696~0.838)、0.709(0.635~0.783)、0.628(0.549~0.706)、0.94(0.901~0.978)];肾小球PLA2R抗体联合IgG4诊断IMN,两者任一阳性的敏感度为93.9%,两者共阳性的特异度高达96.9%。结论 PLA2R和Ig G4能够有效诊断IMN,两者联合检验较单一指标更精确。
[Abstract]:Objective to evaluate the diagnostic value of type M phospholipase A2 receptor PLA2R and IgG4 in elderly patients with primary membranous nephropathy (IMN). Methods from April 2014 to February 2016, the patients with renal biopsies (IMNNNNNX 98) and Non-IMNNNNNNNNNNNNNNNNNNNNNNT98 (Non-IMNNNNX 98) in the Department of Renal Medicine, first affiliated Hospital of Zhengzhou University, were retrospectively analyzed. 106 males and 90 females aged 66.9 卤6.0 years. There were 49 males and 49 females in IMN group. The age of non-IMN group was 66.6 卤5.4 years old. There were 57 males and 41 females with a age of 67.1 卤6.5 years. SPSS 13.0 software was used to calculate the sensitivity, specificity and area under the ROC curve of serum anti-PLA2R antibody, glomerular PLA2R and IgG1-4 subclass in the diagnosis of IMN. Results the results were as follows: the sensitivity and specificity of serum anti-PLA2R antibody in the diagnosis of IMN were 77.6% and 89.8%, respectively; the sensitivity and specificity of glomerular PLA2R in the diagnosis of IMN were 66.3% and 94.9%, respectively; and the diagnostic sensitivity and specificity of glomerular PLA2R in the diagnosis of IMN were 0.8050.7410.870). The sensitivity and specificity of PLA2R and IgG4 were 93.9% and 84.789.8%, respectively. [AUC was 0.7670.696 ~ 0.838 ~ 0.709 ~ 0.7835 ~ 0.6280.5490.7060.7060.901 ~ 0.978]; glomerular antibody combined with IgG4 had a sensitivity of 93.99.The specificity of both was as high as 96.990%. Conclusion PLA2R and IgG 4 are effective in the diagnosis of PLA2R, and the combined test is more accurate than the single index.
【作者单位】：郑州大学第一附属医院肾脏内科;
【分类号】：R692

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