特发性膜性肾病患者肾组织中PLA2R表达及其与免疫治疗疗效的关系

发布时间：2018-06-23 23:34

本文选题：特发性膜性肾病 + M型磷脂酶A受体　；参考：《山东医药》2017年27期

【摘要】：目的观察特发性膜性肾病(IMN)患者肾组织中M型磷脂酶A2受体(PLA2R)的表达情况,并分析其与免疫治疗疗效的关系。方法选取我院肾内科住院治疗且经肾活检病理证实的IMN患者82例,采用免疫荧光法检测患者肾组织中的PLA2R,根据PLA2R表达情况分为PLA2R阳性组和PLA2R阴性组。所有患者给予激素联合环磷酰胺免疫治疗2个月,随访12个月。对比PLA2R阳性组与PLA2R阴性组治疗后3、6、12个月的血清白蛋白水平、24 h尿蛋白定量、治疗总有效率,比较两组治疗时间及不良反应发生率。结果 82例IMN患者中,PLA2R表达阳性58例、阴性24例。IMN患者肾组织中PLA2R阳性表达率为70.73%。PLA2R阳性组患者治疗后3、6、12个月血清白蛋白水平均低于PLA2R阴性组,24 h尿蛋白定量均高于PLA2R阴性组(P均0.05)。PLA2R阳性组治疗后3、6、12个月总有效率均低于PLA2R阴性组(P均0.05)。PLA2R阳性组治疗时间长于PLA2R阴性组,不良反应发生率高于PLA2R阴性组(P均0.05)。结论 IMN患者肾组织中PLA2R阳性表达率较高。PLA2R表达阳性的IMN患者较PLA2R表达阴性者免疫治疗效果差、治疗时间长、不良反应发生率高。
[Abstract]:Objective to observe the expression of type M phospholipase A2 receptor (PLA2R) in renal tissue of idiopathic membranous nephropathy (IMN) and to analyze the relationship between PLA2R and immunotherapy. Methods Eighty-two cases of IMN treated by renal biopsy and pathologically confirmed by renal biopsy in our hospital were selected to detect PLA2Rin renal tissue by immunofluorescence. According to the expression of PLA2R, they were divided into PLA2R positive group and PLA2R negative group. All patients were treated with hormone combined with cyclophosphamide for 2 months and followed up for 12 months. The levels of serum albumin in positive group and PLA2R negative group were compared with those in PLA2R positive group and PLA2R negative group. The 24 h urinary protein level and the total effective rate were measured. The time of treatment and the incidence of adverse reactions were compared. Results the positive expression of PLA2R was found in 58 out of 82 IMN patients. The positive expression rate of PLA2R was 70.73.PLA2R positive in renal tissue of 24 cases with negative. IMN. The serum albumin levels of patients with positive PLA2R were lower than those of PLA2R negative group at 24 h after treatment (P all 0.05). PLA2R positive group was 366 months after treatment, 12 months after treatment, the level of serum albumin was lower than that of PLA2R negative group. The total effective rate of PLA2R negative group was lower than that of PLA2R negative group (P 0.05). The treatment time of PLA2R positive group was longer than that of PLA2R negative group. The incidence of adverse reactions was higher in PLA2R negative group than in PLA2R negative group (P 0.05). Conclusion the positive expression rate of PLA2R in renal tissue of IMN patients is higher than that in IMN patients with positive expression of PLA2R. The immunotherapy effect of IMN patients with positive expression of PLA2R is worse than that of patients with negative expression of PLA2R. The treatment time is longer and the incidence of adverse reactions is higher.
【作者单位】：东莞市人民医院;
【分类号】：R692

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