血清抗M型磷脂酶A2受体抗体、尿IgG4检测在特发性膜性肾病诊断中的应用价值.docxVIP

血清抗M型磷脂酶A2受体抗体、尿IgG4检测在特发性膜性肾病诊断中的应用价值 陈照生 [摘要]目的 探討血清抗M型磷脂酶A2受体（PLA2R）抗体、尿IgG4检测在特发性膜性肾病诊断中的应用价值。方法 选取20XX年3月～20XX年4月我院接收的86例膜性肾病患者，将肾活检术病理检查发现特发性膜性肾病的52例患者纳为特发性组，将34例继发性膜性肾病患者纳为继发性组。采集两组患者的静脉血和中段尿样本进行血清抗PLA2R抗体和尿IgG4指标检测。比较两组患者血清抗PLA2R抗体检测阳性率，分析其特异度、灵敏度、准确率，同时比较两组患者的尿IgG4指标检测结果并进行ROC曲线分析。结果 特发性组的血清抗PLA2R抗体检测阳性率（90.38%）高于继发性组（5.88%），差异有统计学意义（P0.05）。血清抗PLA2R抗体诊断特发性膜性肾病的特异度、灵敏度、准确率分别为94.12%（32/34）、90.38%（47/52）、91.86%（79/86）。特发性组患者的尿IgG4指标为（0.79±0.12）g/L，高于继发性组的（0.52±0.08）g/L，差异有统计学意义（P0.05）。ROC曲线结果显示，尿IgG4诊断特发性膜性肾病的曲线下面积为0.856（检测结果0.7），特异度、灵敏度分别为82.70%、50.00%，诊断价值相对理想。血清抗PLA2R抗体诊断特发性膜性肾病的特异度、灵敏度高于尿IgG4诊断，差异有统计学意义（P0.05）。结论 特发性膜性肾病患者的血清抗PLA2R抗体阳性率、尿IgG4指标明显大于继发性膜性肾病患者，可以用作临床诊断特发性膜性肾病的参考依据。 [关键词]血清抗PLA2R抗体;尿IgG4;特发性膜性肾病;诊断价值 [中图分类号] R446.11 [文献标识码] A [文章编号] 1674-4721（2020）7（c）-0148-04 Application value of serum anti-M-type phospholipase A2 receptor antibody and urine IgG4 detection in the diagnosis of idiopathic membranous nephropathy CHEN Zhao-sheng Department of Clinical Laboratory， Qingdao Third People′s Hospital， Shandong Province， Qingdao 266000， China [Abstract] Objective To investigate the application value of serum anti-M-type phospholipase A2 receptor （PLA2R） antibody and urine IgG4 detection in the diagnosis of idiopathic membranous nephropathy. Methods From March 20XX to April 20XX， 86 patients with membranous nephropathy in our hospital were selected， and 52 cases of idiopathic membranous nephropathy found by renal biopsy were included in the idiopathic group， 34 cases of secondary membranous nephropathy were included in the secondary group. The venous blood and mid-range urine samples were collected from two groups of patients for detecting serum PLA2R antibody and urine IgG4 indicators. The positive rate of serum anti PLA2R antibody was compared between the two groups， and the specificity， sensitivity and accuracy were analyzed. At the same time， the results of urine IgG4 of the two groups were compared and ROC curv