血清抗M型磷脂酶A2受体抗体与特发性膜性肾病脾肾阳虚证的关联探讨

发布时间：2018-01-03 20:03

本文关键词：血清抗M型磷脂酶A2受体抗体与特发性膜性肾病脾肾阳虚证的关联探讨　出处：《辽宁中医杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的:探讨血清抗M型磷脂酶A2受体抗体(antibody to M-type phospholipase A2 receptor,anti-PLA2R)与特发性膜性肾病(idiopathic membranous nephropathy,IMN)脾肾阳虚证的关联。方法:选取2014年1月—2015年9月广州中医药大学第一附属医院肾病科住院患者,临床表现为肾病综合征(nephrotic syndrome,NS),经肾穿刺活检确诊的IMN患者40例,其中脾肾阳虚证31例,非脾肾阳虚证9例。采用酶联免疫吸附法检测患者血清anti-PLA2R,判断anti-PLA2R阴阳性。比较两组一般资料、实验室检查[血清白蛋白(ALB)、血清球蛋白(GLO)、血肌酐(Scr)、尿酸(UA)、甘油三酯(TG)、总胆固醇(CHOL)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、24 h尿蛋白总量(UTP)、尿红细胞计数(RBC(HPF))]、病理指标(系膜增生、新月体、肾小球硬化、肾小管萎缩/纤维化、肾间质炎症细胞浸润、肾间质血管病变及免疫荧光沉积);并对anti-PLA2R与两组差异有统计学意义指标分别行相关性分析。结果:脾肾阳虚组患者血清anti-PLA2R阳性率为70.97%,非脾肾阳虚组为33.33%,差异无统计学意义;脾肾阳虚组患者年龄、血清anti-PLA2R光密度、血清球蛋白水平均高于非脾肾阳虚组,差异均有统计学意义(P0.05);病理指标方面,两组肾间质炎症细胞浸润构成比差异有统计学意义(P0.05);脾肾阳虚组血清anti-PLA2R光密度与血清球蛋白呈正相关。结论:IMN脾肾阳虚证与血清anti-PLA2R存在一定的关联。
[Abstract]:Objective: To investigate the serum anti M phospholipase A2 receptor antibody (antibody to M-type phospholipase A2 receptor, anti-PLA2R) with idiopathic membranous nephropathy (idiopathic membranous, nephropathy, IMN) associated with spleen deficiency syndrome. Methods: from January 2014 to September 2015 in the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Department of nephropathy patients with nephrotic syndrome (nephrotic syndrome, NS), 40 cases with renal biopsy confirmed IMN patients, including 31 cases of spleen kidney yang deficiency syndrome, 9 cases of non Yang deficiency of spleen and kidney. The ELISA detection of serum anti-PLA2R in patients with anti-PLA2R to determine the adsorption, and compared between the two groups. The general information, laboratory examination [serum albumin (ALB), serum globulin protein (GLO), serum creatinine (Scr), uric acid (UA), triglyceride (TG), total cholesterol (CHOL), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), plasma coagulation Prothrombin time (PT), activated partial thromboplastin time (APTT), 24 h urine total protein (UTP), urine red blood cell count (RBC (HPF)), pathological index (mesangial proliferative, crescentic, glomerulosclerosis, tubular atrophy / fibrosis, renal interstitial inflammatory cell infiltration in renal interstitial. Vascular lesions and immunofluorescence deposition); and there is a statistically significant indicators were performed to analysis the correlation of anti-PLA2R and the differences between the two groups. Results: the positive rate of serum anti-PLA2R in patients with spleen kidney yang deficiency group was 70.97%, the non spleen kidney yang deficiency group was 33.33%, the difference was not statistically significant; Spleen Kidney Yang deficiency group with age, serum anti-PLA2R density, serum immunoglobulin levels were higher than those of spleen and kidney yang deficiency group, the differences were statistically significant (P0.05); pathological indicators, two groups of renal interstitial inflammatory cell infiltration of the differences were statistically significant (P0.05); spleen kidney yang deficiency group serum anti-PLA2R and serum globulin in optical density Positive correlation. Conclusion: there is a certain association between the deficiency of the spleen and kidney of IMN and the serum anti-PLA2R.

【作者单位】：广州中医药大学第一附属医院;
【基金】：国家自然科学基金资助项目(81373568)
【分类号】：R277.5
【正文快照】： 特发性膜性肾病(idiopathic membranous nephropa-thy,IMN)属于膜性肾病(membranous nephropathy,MN)的范畴,在病理诊断MN后,应首先排除继发因素,才可诊断为IMN。IMN是原发性肾病综合征(ne-phrotic syndrome,NS)最常见的原因,占30%~40%;欧洲每年有10,000例新确诊患者[1];在我

【相似文献】