膜性肾病患者肾组织M型磷脂酶A2受体1抗原及其抗体的表达差异

发布时间：2018-06-20 02:19

本文选题：特发性膜性肾病 + 乙型肝炎病毒相关性膜性肾病　；参考：《重庆医学》2017年18期

【摘要】：目的探讨肾组织M型磷脂酶A2受体1(PLA2R1)抗原及其抗体在膜性肾病(MN)患者中的表达水平。方法选取经肾活检证实的特发性MN(IMN)58例、乙型肝炎病毒相关性MN(HBV-MN)15例、V型狼疮性肾炎(V-LN)17例。采用间接免疫荧光法检测肾组织PLA2R1抗原,并与IgG4共定位。同时检测上述MN患者血清抗PLA2R1抗体。分析肾组织PLA2R1抗原及其抗体在MN中的表达差异,以及PLA2R1阳性与阴性患者临床资料的差异。结果 V-LN及HBV-MN患者肾组织及血清中均未发现PLA2R1抗体;在81.03%IMN患者肾组织检测到PLA2R1抗原,70.69%IMN患者血清中检测到PLA2R1抗体,PLA2R1抗原与IgG4共定位,均沿肾小球毛细血管袢呈细颗粒状沉积。PLA2R1抗原阳性患者24h尿蛋白定量高于阴性患者(P0.05),并且血清清蛋白低于阴性患者(P0.05)。结论肾组织PLA2R1抗原在IMN的诊断中敏感性及特异性均较高,且表达与临床病情严重性明显相关。
[Abstract]:Objective to investigate the expression of type M phospholipase A 2 receptor 1 (PLA 2 R 1) antigen and its antibody in patients with membranous nephropathy (MN). Methods 58 cases of Idiopathic MNNMN, 15 cases of HBV associated MNV and 17 cases of V type lupus nephritis confirmed by renal biopsy were selected. PLA 2 R 1 antigen was detected by indirect immunofluorescence assay and co-located with IgG 4. At the same time, the serum anti-PLA 2 R 1 antibody was detected in the above MN patients. To analyze the difference of expression of PLA2R1 antigen and antibody in MN and the clinical data of PLA2R1 positive and negative patients. Results PLA2R1 antibody was not found in renal tissue and serum of patients with V-LN and HBV-MN, PLA2R1 antigen was detected in renal tissue of 81.03IMN patients and PLA2R1 antibody was detected in IMN patients' serum. The 24-hour urinary protein quantity in the patients with positive antigen of PLA2R1 was higher than that in the negative patients (P 0.05), and the serum albumin was lower than that in the negative patients (P 0.05). Conclusion the sensitivity and specificity of renal PLA2R1 antigen in the diagnosis of IMN are high, and the expression of PLA2R1 antigen is significantly related to the severity of the clinical condition.
【作者单位】：南方医科大学附属南海医院肾内科;南方医科大学附属南海医院检验科;南方医科大学附属南海医院病理科;
【基金】：佛山市卫生和计划生育委员会医学科研课题(20160213)
【分类号】：R692

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