抗磷脂酶A2受体抗体检测在特发性膜性肾病诊断中的意义

摘要

Objective To discuss the significance of anti-phospholipase A2 receptor antibody (anti-PLA2R) in diagnosing idiopathic membranous nephropathy. Methods Anti-PLA2R in the blood was detected by indirect im-munofluorescence in the patients with idiopathic membranous nephropathy (IMN group), and then compared with those in the patients with secondary membranous nephropathy (secondary membranous nephropathy group) and healthy blood donors (healthy control group). The relationship between anti-PLA2R and pathological diagnosis of re-nal tissue was analyzed. Results For detection of anti-PLA2R in blood by indirect immunofluorescence, the sensibility was 76.7%and the specificity was 96.7%. Only one case was positive in the secondary membranous nephropathy group, and none was positive in the healthy control group. Correlation analysis between anti-PLA2R and pathological diagno-sis showed a positive coincidence rate of 97.9%, negative coincidence rate of 80.8%, total coincidence rate of 87.5%, and the Kappa of consistency test of 0.752, P<0.01. Conclusion Anti-PLA2R in blood detected by indirect immunoflu-orescence could be used as the specific indicator for diagnosing idiopathic membranous nephropathy in vitro.%目的：探讨血液中抗磷脂酶A2受体抗体(anti-PLA2R)在特发性膜性肾病诊断中的意义。方法应用间接免疫荧光方法检测特发性膜性肾病患者血液中的anti-PLA2R，以继发性膜性肾病患者及健康献血员作为对照，分析其与肾活检组织中病理诊断的相关性。结果间接免疫荧光方法检测血液中的anti-PLA2R敏感性为76.7%、特异性为96.7%。继发性膜性肾病组仅检出1例阳性，正常组未检出阳性。血液anti-PLA2R与病理诊断的相关性分析发现其阳性符合率为97.9%，阴性符合率为80.8%，总符合率为87.5%，Kappa一致性检验，Kappa=0.752，P<0.01。结论间接免疫荧光方法检测血液中的anti-PLA2R可成为体外诊断特发性膜性肾病的特异性指标。