血清M型磷酸酯酶A2受体联合肾组织IgG 4的检测对成人特发性膜性肾病的诊断价值及临床意义

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Abstract Objective To investigate the diagnostic value and clinical significance of detecting serum M-type phosphatase A2 receptor (PLA2R) combined with renal tissue immunoglobulin 4 (IgG 4) in idiopathic membranous nephropathy (IMN) in adults. Methods The clinical data of 70 patients with membranous nephropathy admitted to Xinyu People′s Hospital from April 2017 to April 2019 were retrospectively collected, and divided into IMN group (30 cases) and secondary membranous nephropathy group (40 cases) according to the etiology. All patients received serum PLA2R and renal tissue IgG 4 detection, and the diagnostic value of serum PLA2R combined with renal tissue IgG 4 detection for IMN was analyzed. Results The level of serum PLA2R in IMN group was higher than that in SMN group, and the difference was statistically significant (P<0.05). The ROC curve was drawn with serum PLA2R level as the test variable and the incidence of IMN disease as the dependent variable (1=IMN, 0=SMN). The diagnostic threshold of IMN was 25.641 RU/mL of serum PLA2R, when serum PLA2R>25.641 RU/mL was identified as IMN. At this time, the diagnostic AUC was 0.919 (P<0.05). The diagnostic accuracy of serum PLA2R and renal tissue IgG 4 combined detection for IMN was 93.33%, which was higher than that of serum PLA2R and renal tissue IgG 4 alone detection (81.43%,85.71%), the differences were statistically significant (P<0.05). The serum levels of PLA2R and renal tissue IgG 4 alone in detecting IMN were in good consistency with renal biopsy (Kappa=0.622, 0.706). Combined detection of IMN and renal biopsy showed great consistency (Kappa=0.912). Conclusion The detection of serum PLA2R combined with renal tissue IgG 4 has a high diagnostic value for IMN disease. Targeted preventive measures can be made in time according to the detection results of serum PLA2R combined with renal tissue IgG 4 in clinical practice.

Key words： Idiopathic membranous nephropathy Secondary membranous nephropathy M-type phosphatase A2 receptor Immunoglobulin 4 Diagnostic value

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	JIANG Fang
	ZHOU Qun
	KANG Wen-ling
	JIANG Xiao-lin
	LIU Jin-mei

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JIANG Fang,ZHOU Qun,KANG Wen-ling, et al. iagnostic value and clinical significance of detecting serum M -type phosphatase A2 receptor combined with renal tissue IgG 4 in adults with idiopathic membranous nephropathy[J]. 中国当代医药, 2021, 28(16): 105-107转111.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I16/105

[1]	Inaguma Y，Shiratori A，Nakagawa T，et al.M-Type phospholipase A2 receptor staining in children with idiopathic membranous nephropathy： PLA2R staining in children with IMN[J].N Engl J Med，2019，12（1）：27-32.
[2]	纪春阳，边学燕，包斯增.血清PLA2R 抗体、肾小球PLA2R及IgG 4 检测在膜性肾病诊断中的作用[J].中国卫生检验杂志，2018，28（17）：2138-2140.
[3]	麦李明，石俊婷.抗磷脂酶A2 受体抗体在成人特发性膜性肾病患者中的应用探讨[J].中国实验诊断学，2017，21（9）：1510-1513.
[4]	刘晓斌，张秋花，陈勇，等.特发性膜性肾病临床、病理特点及M 型磷脂酶A2 受体表达的相关分析[J].实用医学杂志，2017，33（15）：102-106.
[5]	叶任高，刘冠贤.临床肾脏病学[M].北京：人民卫生出版社，1997：169-1171.
[6]	Wang J，Xie Q，Sun Z，et al.Response to immunosuppressive therapy in PLA2R-associated and non-PLA2R- associated idiopathic membranous nephropathy：a retrospective，multicenter cohort study[J].BMC Nephrol，2017，18（1）：227-229.
[7]	刘晓斌，王凉，孙铸兴，等.老年特发性膜性肾病临床病理特点及M 型磷脂酶A2 受体表达的相关分析[J].中华老年医学杂志，2018，37（6）：621-625.
[8]	鲁欢，涂海涛，苏保林，等.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[J].辽宁中医杂志，2017，44（5）：905-909.
[9]	袁文明，程根阳，李炎生，等.PLA2R 和IgG 4 对老年原发性膜性肾病的诊断价值[J].解放军医学杂志，2017，42（9）：810-814.
[10]	项美娟，马雁鸿，俞斌峰，等.肾小球IgG 4 沉积与原发性膜性肾病临床及病理的关系[J].中华肾脏病杂志，2020，36（2）：94-100.
[11]	计蕾，余慰，钟雪.特发性膜性肾病患者血清抗磷脂酶A2 受体抗体与尿中IgG 4 检测的临床意义[J].中国免疫学杂志，2018，34（7）：1050-1053.
[12]	董燕飞，朱光华，黄文彦，等.儿童原发性膜性肾病临床特点及肾组织M 型磷脂酶A2 受体的表达[J].中华儿科杂志，2018，56（3）：206-210.
[13]	赵莉，师新宇.特发性膜性肾病与血清抗M 型磷脂酶A2受体抗体的相关性分析[J].中国药物与临床，2019，19（2）：267-269.
[14]	黄飚，王凉，肖华龙，等.M 型磷脂酶A2 受体抗体高灵敏定量方法的建立及临床应用[J].中国实验诊断学，2017，21（11）：1927-1932.
[15]	洪国保，赵学峰，吴晓婵，等.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[J].重庆医学，2017，46（18）：2461-2463，2467.