特发性膜性肾病血清抗M型磷脂酶A2受体抗体（PLA2R-Abs）与幽门螺杆菌感染关系的研究

发布时间：2018-06-28 23:58

本文选题：特发性膜性肾病 + PLA2R-Abs　；参考：《河北医科大学》2017年硕士论文

【摘要】：目的:检测特发性膜性肾病患者血清抗PLA2R抗体(PLA2R-Abs)及幽门螺杆菌感染情况,探讨幽门螺杆菌感染与特发性膜性肾病血清抗PLA2R抗体和临床指标的关系。方法:1选取2014年1月至2016年6月于邢台市人民医院肾脏内科住院经肾脏病理诊断为特发性膜性肾病患者60例,记录入选患者的一般资料。2实验分组1)根据IMN患者蛋白尿定量程度分为轻危(尿蛋白4.0g/d)组,中危(尿蛋白4-6g/d)和高危(尿蛋白6.0g/d)组。2)根据血清抗体检测结果分为PLA2R-Abs阳性组和PLA2R-Abs阴性组。3)根据14C呼气试验结果分为HP感染组和无HP感染组。3血清PLA2R-Abs的检测采用双抗体两步夹心酶联免疫吸附法(ELISA);使用14C呼气实验检测幽门螺杆菌感染情况。4统计分析:应用SPSS软件对用Microsoft Excel建立的资料库的数据进行统计学处理。结果:1血清PLA2R-Abs的阳性例数48例,阳性率80%。IMN患者PLA2R-Abs阳性组血清白蛋白较PLA2R-Abs阴性组显著降低,差异有统计学意义(P0.05),尿蛋白定量、胆固醇、肌酐较阴性组显著升高,差异有统计学意义(P0.05)。2 M型血清PLA2抗体大于0.1ug/ml的患者48例,阳性率80%。高危组患者血清PLA2R-Abs浓度显著高于中危组和轻危组(P0.05)。血清白蛋白随着蛋白尿程度的增加进行性减低(P0.05);血胆固醇和甘油三脂水平随着蛋白尿程度的增加逐渐升高(P0.05);高危组患者血肌酐显著高于中危组(P0.05)。3 HP阳性结果有43例,总感染率为71.7%。HP阳性组与阴性组比较血肌酐水平、尿蛋白定量显著升高,差异有统计学意义(P0.05);阳性组血清白蛋白较阴性组显著降低,差异有统计学意义(P0.05)。4 HP阳性组与HP阴性组比较,血清PLA2R阳性率显著升高,血清PLA2R水平明显高于HP阴性组,差异有统计学意义(P0.05)。5 PLA2R-Abs与各个变量进行直线相关分析,提示抗PLA2抗体与尿蛋白定量、血清肌酐呈显著正相关,与血清白蛋白呈显著负相关(P0.05)。HP感染与各个变量进行直线分析,提示HP感染与尿蛋白定量、血清肌酐呈显著正相关,与血清白蛋白呈显著负相关(P0.05)。结论:1血清PLA2R-Abs是诊断IMN的无创特异性生物学指标,且与IMN病情密切相关。其特异度和敏感度均较高,且PLA2R抗体滴度对疾病活动、病情缓解和复发有预测价值。2 IMN患者常伴随HP感染存在,HP感染与血清PLA2R-Abs和尿蛋白、血清白蛋白、血肌酐存在相关性。
[Abstract]:Objective: to detect the serum anti PLA2R antibody (PLA2R-Abs) and Helicobacter pylori infection in patients with idiopathic membranous nephropathy, and to explore the relationship between Helicobacter pylori infection and serum anti PLA2R antibody and clinical indexes of idiopathic membranous nephropathy. Methods 1 from January 2014 to June 2016 in the nephrology department of Xingtai People's Hospital. 60 cases of idiopathic membranous nephropathy were broken, and the general data of the selected patients were recorded in the.2 experiment group 1) according to the degree of proteinuria in IMN patients, they were divided into light risk (urine protein 4.0g/d) group, middle risk (urine protein 4-6g/d) and high risk (urine protein 6.0g/d) group.2) according to serum anti physical examination results into PLA2R-Abs positive group and PLA2R-Abs negative group.3) according to 14C. The results of exhalation test were divided into HP infection group and non HP infection group,.3 serum PLA2R-Abs was detected by double antibody two step sandwich enzyme-linked immunosorbent assay (ELISA); 14C breath test was used to detect Helicobacter pylori infection in.4 statistical analysis: the data of the database established with Microsoft Excel was statistically processed with SPSS software. Results: 1 The number of positive cases of serum PLA2R-Abs in 48 cases, the positive rate of 80%.IMN patients with PLA2R-Abs positive group was significantly lower than that of the PLA2R-Abs negative group, the difference was statistically significant (P0.05), the urine protein quantitative, cholesterol, creatinine was significantly higher than the negative group, the difference was statistically significant (P0.05) the.2 M serum PLA2 antibody was greater than the 0.1ug/ml of the 48 patients, The serum PLA2R-Abs concentration in the positive rate 80%. group was significantly higher than that in the middle risk group and the light risk group (P0.05). The serum albumin was decreased with the increase of the proteinuria (P0.05); the level of blood cholesterol and glycerol three fat increased with the increase of proteinuria (P0.05); the serum creatinine of the high-risk group was significantly higher than that of the middle risk group (P0.05).3 HP The positive results were 43 cases, the total infection rate was 71.7%.HP positive group and the negative group compared with the serum creatinine level, the urine protein quantitative significantly increased, the difference was statistically significant (P0.05), the positive group serum albumin was significantly lower than the negative group, the difference was statistically significant (P0.05).4 HP positive group compared with HP negative group, serum PLA2R positive rate increased significantly. The level of PLA2R was significantly higher than that of HP negative group, the difference was statistically significant (P0.05).5 PLA2R-Abs was correlated with each variable, suggesting that anti PLA2 antibody and urine protein quantitative, serum creatinine was positively correlated, and serum albumin was negatively correlated with serum albumin (P0.05).HP infection and linear analysis of each variable, suggesting HP infection and urine egg. There was a significant positive correlation between serum creatinine and serum creatinine (P0.05). Conclusion: 1 serum PLA2R-Abs is a noninvasive biological index for diagnosis of IMN, and is closely related to the condition of IMN. Its specificity and sensitivity are high, and the PLA2R antibody titer has a predictive value of.2 IMN for disease activity, disease remission and recurrence. HP infection is often associated with HP infection, which is associated with serum PLA2R-Abs and urine protein, serum albumin and serum creatinine.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692

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