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目的探讨特发性膜性肾病(idiopathic membranous nephropathy,IMN)血清抗M型磷脂酶A_2受体(M-type phospholipase A_2receptor,PLA_2R)抗体的表达及其在IMN诊断中的价值。方法经肾活检组织病理证实IMN患者70例为IMN组,周期体检健康者20例为对照组。采用ELISA法检测2组血清抗PLA_2R抗体水平,分析IMN患者血清抗PLA_2R抗体水平与血清白蛋白、24h尿蛋白相关性。结果 IMN组血清抗PLA_2R抗体阳性51例(72.85%),对照组均为阴性(0);IMN组血清抗PLA_2R抗体水平[40.5(3.1,764.3)RU/mL]明显高于对照组[5.9(2.1,11.2)RU/mL](P<0.05);IMN患者血清抗PLA_2R抗体水平与24h尿蛋白呈正相关(r=0.541,P=0.000),与血清白蛋白呈负相关(r=-0.387,P=0.004)。结论IMN患者血清抗PLA_2R抗体表达阳性率高,抗PLA_2R抗体可能是IMN的特异性抗体,可用于IMN的诊断和病情评估。
Objective To investigate the expression of anti-M-phospholipase A_2 receptor (PLA_2R) in idiopathic membranous nephropathy (IMN) serum and its diagnostic value in IMN. Methods Totally 70 IMN patients with IMN were confirmed by histopathology of renal biopsy. Twenty healthy subjects were selected as the control group. The levels of anti-PLA2R antibody in serum of two groups were detected by ELISA, and the correlation between serum anti-PLA2R antibody levels and serum albumin and 24h urinary protein in IMN patients was analyzed. Results Serum levels of anti-PLA2R antibody in IMN group were 51 (72.85%) positive and negative in control group (0). The serum anti-PLA2R antibody level in IMN group was significantly higher than that in control group [40.5 (3.1,764.3) RU / mL (R = -0.387, 2.1, 11.2) RU / mL] (P <0.05). The level of serum anti-PLA2R antibody in IMN patients was positively correlated with 24h urinary protein (r = 0.541, P = 0.004). Conclusion The positive expression rate of anti-PLA2R antibody in IMN patients is high. Anti-PLA2R antibody may be the specific antibody of IMN, which can be used in the diagnosis and assessment of IMN.