血清抗M型磷脂酶A2受体抗体、尿IgG4检测在特发性膜性肾病诊断中的应用价值

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摘要目的探讨血清抗M 型磷脂酶A2 受体（PLA2R）抗体、尿IgG4 检测在特发性膜性肾病诊断中的应用价值。方法选取2016年3月～2019年4月我院接收的86 例膜性肾病患者，将肾活检术病理检查发现特发性膜性肾病的52 例患者纳为特发性组，将34 例继发性膜性肾病患者纳为继发性组。采集两组患者的静脉血和中段尿样本进行血清抗PLA2R 抗体和尿IgG4 指标检测。比较两组患者血清抗PLA2R 抗体检测阳性率，分析其特异度、灵敏度、准确率，同时比较两组患者的尿IgG4 指标检测结果并进行ROC 曲线分析。结果特发性组的血清抗PLA2R抗体检测阳性率（90.38%）高于继发性组（5.88%），差异有统计学意义（P＜0.05）。血清抗PLA2R 抗体诊断特发性膜性肾病的特异度、灵敏度、准确率分别为94.12%（32/34）、90.38%（47/52）、91.86%（79/86）。特发性组患者的尿IgG4指标为（0.79±0.12）g/L，高于继发性组的（0.52±0.08）g/L，差异有统计学意义（P＜0.05）。ROC 曲线结果显示，尿IgG4诊断特发性膜性肾病的曲线下面积为0.856（检测结果＞0.7），特异度、灵敏度分别为82.70%、50.00%，诊断价值相对理想。血清抗PLA2R 抗体诊断特发性膜性肾病的特异度、灵敏度高于尿IgG4 诊断，差异有统计学意义（P＜0.05）。结论特发性膜性肾病患者的血清抗PLA2R 抗体阳性率、尿IgG4 指标明显大于继发性膜性肾病患者，可以用作临床诊断特发性膜性肾病的参考依据。

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关键词 ：血清抗PLA2R 抗体, 尿IgG4, 特发性膜性肾病, 诊断价值

Abstract：Objective To investigate the application value of serum anti-M-type phospholipase A2 receptor (PLA2R)antibody and urine IgG4 detection in the diagnosis of idiopathic membranous nephropathy. Methods From March 2016 to April 2019,86 patients with membranous nephropathy in our hospital were selected,and 52 cases of idiopathic membranous nephropathy found by renal biopsy were included in the idiopathic group,34 cases of secondary membranous nephropathy were included in the secondary group.The venous blood and mid-range urine samples were collected from two groups of patients for detecting serum PLA2R antibody and urine IgG4 indicators.The positive rate of serum anti PLA2R antibody was compared between the two groups,and the specificity,sensitivity and accuracy were analyzed.At the same time,the results of urine IgG4 of the two groups were compared and ROC curve was analyzed. Results The positive rate of serum anti-PLA2R antibody detection in the idiopathic group (90.38%) was higher than that in the secondary group (5.88%),the difference was statistically significant (P＜0.05).The specificity,sensitivity and accuracy of serum anti PLA2R antibody in the diagnosis of idiopathic membranous nephropathy were 94.12% (32/34),90.38% (47/52) and 91.86% (79/86),respectively.The urinary IgG4 in the idiopathic group was (0.79±0.12) g/L,which was higher than that in the secondary group ([0.52±0.08]g/L),the difference was statistically significant (P＜0.05).The ROC curve showed that the area under the curve of urine IgG4 in the diagnosis of idiopathic membranous nephropathy was 0.856 (detection result ＞0.7),the specificity and sensitivity were 82.70% and 50.00%,respectively.The diagnostic value was relatively ideal.The specificity and sensitivity of serum anti PLA2R antibody in the diagnosis of idiopathic membranous nephropathy were higher than those of urine IgG4,the differences were statistically significant (P＜0.05).Conclusion The positive rate of serum anti PLA2R antibody and urine IgG4 in patients with idiopathic membranous nephropathy are significantly higher than those in patients with secondary membranous nephropathy,which can be used as a reference for clinical diagnosis of idiopathic membranous nephropathy.

Key words： Serum anti-PLA2R antibody Urine IgG4 Idiopathic membranous nephropathy Diagnostic value

作者简介: 陈照生（1964-），男，汉族，山东青岛人，本科，主管技师，研究方向：生化免疫检验

引用本文:

陈照生. 血清抗M型磷脂酶A2受体抗体、尿IgG4检测在特发性膜性肾病诊断中的应用价值[J]. 中国当代医药, 2020, 27(21): 148-151.
CHEN Zhao-sheng. Application value of serum anti-M-type phospholipase A2 receptor antibody and urine IgG4 detection in the diagnosis of idiopathic membranous nephropathy. 中国当代医药, 2020, 27(21): 148-151.

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https://dangdaiyiyao.com/CN/ 或 https://dangdaiyiyao.com/CN/Y2020/V27/I21/148

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