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目的:探讨磷脂酶A2受体(PLA2R)抗原在特发性膜性肾病(IMN)肾组织中的表达情况及其与IMN临床特征、预后的关联性。方法:选择2008年1月至2018年1月本院经肾穿刺活检确诊的肾小球疾病患者292例，其中156例IMN、45例继发性膜性肾病，另91例为非膜性肾病，免疫荧光法检测各组患者肾组织中PLA2R抗原情况。进一步将IMN患者分成PLA2R抗原阳性组(阳性组，116例)及PLA2R抗原阴性组(阴性组，40例)，并对两组临床特征及预后相关指标进行对比分析。结果:PLA2R抗原在IMN、继发性膜性肾病、非膜性肾病患者的阳性率分别为74.4%(116/156)、11.1%(5/45)、0，IMN中PLA2R抗原阳性率最高(χn 2＝16.338，n P＝0.006)。IMN患者中阴性组以Ⅰ期膜性肾病为主(90%，36/40)，阳性组则以Ⅱ期膜性肾病为主(62.9%，73/116)，差异有统计学意义(χn 2＝8.230，n P＝0.029)。阴性组经激素或激素联合免疫抑制治疗12个月的完全缓解率(79.4%，27/34)明显高于阳性组(43.6%，44/101)，差异有统计学意义(χn 2＝10.656，n P＝0.021)。n 结论:肾组织PLA2R抗原对诊断IMN有重要意义，与IMN患者病理分期有相关性，且PLA2R抗原表达阴性患者可能预测预后较好。“,”Objective:To explore the relationship of phospholipase A2 receptor (PLA2R) antigen expression in renal tissue with clinical characteristics, prognosis of idiopathic membranous nephropathy (IMN) patients.Methods:292 patients with nephropathy diagnosed by renal biopsy from January 2008 to January 2018 were selected, including 156 cases of IMN, 45 cases of secondary membranous nephropathy, and 91 cases of non membranous nephropathy. The PLA2R antigen in renal tissues of each patient was detected by immunofluorescence. Patients with IMN were further divided into PLA2R antigen positive group (116 cases) and PLA2R antigen negative group (negative group, 40 cases), and the clinical characteristics and prognostic indicators of the two groups were compared and analyzed.Results:The positive rates of PLA2R antigen in IMN, secondary membranous nephropathy and non membranous nephropathy were 74.4%(116/156), 11.1%(5/45) and 0, respectively. The positive rate of PLA2R antigen in IMN was the highest (χn 2=16.338, n P=0.006). In IMN patients, the majority of IMN patients were stage I membranous nephropathy (90%, 36/40) and stage II membranous nephropathy (62.9%, 73/116) in the positive group (χn 2=8.230, n P=0.029). The complete remission rate of the negative group (79.4%, 27/34) was significantly higher than that of the positive group (43.6%, 44/101), and the difference was statistically significant (χn 2=10.656, n P=0.021).n Conclusions:The expression of PLA2R antigen in renal tissue plays an important role in the diagnosis of IMN, and it′s correlated with the pathological stage of IMN. The negative PLA2R in kidney tissue of IMN may indicate a good clinical prognosis.