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目的研究血清IgG亚型在特发性膜性肾病(idiopathic membranous nephropathy,IMN)患者的分布及对该病的诊断价值。方法血清采自60例IMN患者、21例狼疮肾(systemic lupus erythematosus nephritis,SLEN)患者和40例健康对照组。采用特定蛋白仪检测受试者血清IgG1、IgG2、IgG3和IgG4水平。结果 3组血清IgG1、IgG2、IgG3、IgG4和IgG4/IgG3比率之间比较差异均有统计学意义(P<0.05)。特发性膜性肾病组血清IgG1明显低于狼疮肾组和健康对照组,IgG4/IgG3比率明显高于狼疮肾组和健康对照组;狼疮肾组血清IgG2、IgG3、IgG4水平明显低于对照组,差异均有统计学意义(P<0.05)。ROC曲线分析显示IgG1和IgG4/IgG3的曲线下面积(area under the curve,AUC)分别为0.994和0.980。结论本文首次研究血清IgG1及IgG4/IgG3比率对于诊断和鉴别诊断IMN有重要作用。
Objective To investigate the distribution of serum IgG subtypes in patients with idiopathic membranous nephropathy (IMN) and its diagnostic value. Methods Serum was collected from 60 patients with IMN, 21 patients with systemic lupus erythematosus nephritis (SLEN) and 40 healthy controls. Subjects were tested for serum IgG1, IgG2, IgG3 and IgG4 levels using a specific protein detector. Results The serum IgG1, IgG2, IgG3, IgG4 and IgG4 / IgG3 ratios in the three groups were significantly different (P <0.05). The serum IgG1 in idiopathic membranous nephropathy group was significantly lower than that in lupus nephropathy group and healthy control group, and the IgG4 / IgG3 ratio was significantly higher than that in lupus kidney group and healthy control group. The levels of IgG2, IgG3 and IgG4 in lupus nephropathy group were significantly lower than those in control group , The differences were statistically significant (P <0.05). ROC curve analysis showed that the area under the curve (AUC) of IgG1 and IgG4 / IgG3 were 0.994 and 0.980, respectively. Conclusion The first study of serum IgG1 and IgG4 / IgG3 ratio for the diagnosis and differential diagnosis of IMN have an important role.