Expression Of PLA2R In Membranous Nephropathy

Objective1.To detect the expression of anti-PLA2 R antibody in MN,compare the clinical characteristics of anti-PLA2 R antibody positive group and negative group,explore the relationship between anti-PLA2 R antibody level and clinical related indicators,and evaluate disease The ability to return.2.To compare the clinical characteristics of AMN 、 IMN patients,anti-PLA2 R antibody levels,and to evaluate whether serum PLA2 R antibody levels can distinguish between AMN and IMN.Methods1.Data collection: From November 2017 to November 2018,a renal biopsy was performed at the Shanxi Provincial People’s Hospital for diagnosis of MN patients.Among them,there were 56 cases of IMN,16 cases of SMN,and 18 cases of IMN.General clinical data of all patients were collected: gender,age,current medical history,past history;laboratory indicators: urea nitrogen(UN),serum creatinine(Scr),uric acid(UA),triglyceride(TG),total cholesterol(TC),serum albumin(Alb),serum complement C3,C4,serum IgG,hemoglobin,24 hour urine protein quantification;serum anti-PLA2 R antibody concentration was determined by ELSA method.Eighteen patients with IMN treated with hormone-conjugated cyclophosphamide were followed up for 6 months.2.Experimental design:(1)Comparison of basic data of patients enrolled in the study(2)Analysis of serum PLA2 R antibody positive rate in patients with IMN,SMN and AMN(3)Correlation between serum PLA2 R antibody levels and conventional biochemical indicators in IMN,SMN and AMN patients Differences in serum PLA2 R antibody levels between different sexes in patients with IMN,SMN and AMN groups(4)Comparison of clinical data between Anti-PLA2 R positive group and Anti-PLA2 R negative group between IMN,SMN and AMN groups(5)Comparison of basic and clinical data among three groups of patients with serum PLA2 R antibody positive(6)Comparison of serum PLA2 Rconcentrations between remission and non-remission groups before and after treatment(7)Correlation between serum PLA2 R antibody levels,urine protein quantitation and remission using two-class logistic regression analysis.Results1.There were significant differences in gender and age between patients with IMN,SMN and AMN(P<0.05).Among them,patients with idiopathic membranous nephropathy were predominantly male,and patients with secondary membranous nephropathy were predominantly female.AMN patients are younger than IMN.There is no significant difference between atypical membranous nephropathy and idiopathic membranous nephropathy in various clinical indicators.2.In patients with idiopathic membranous nephropathy,the positive rate of serum anti-PLA2 R antibody was 82.1%;the positive rate was 23% in patients with secondary membranous nephropathy;the positive rate of serum anti-PLA2 R antibody in patients with atypical membranous nephropathy was 27.8%.After removing confounding factors,serum anti-PLA2 R antibody levels were different in IMN,SMN,and AMN groups,and the mean serum anti-PLA2 R antibody concentration after IMN correction was significantly higher than the other two groups.3.In patients with IMN and AMN,serum PLA2 R antibody levels were positively correlated with 24-hour urine protein quantitation.Serum PLA2 R antibody levels in SMN patients are inversely related to hemoglobin.In patients with IMN,male anti-PLA2 R antibody levels were higher in women than in women.4.The serum PLA2 R antibody positive group and the negative group of IMN and AMN patients had significant difference in 24 h urine protein quantitation(P<0.05).The difference of serum related factors between serum TNFH positive group and negative group in secondary membranous nephropathy Not large(P<0.05).5.PLA2 R antibody positive IMN,SMN and AMN group,in gender,age,urine protein quantitation,urea nitrogen,hemoglobin,cholesterol,IgG(mg / dL),C4(mg / L),C3(mg /L),In the PLA2 R concentration and other indicators,the difference between the large groups was statistically significant;among the gender,hemoglobin,IgG(mg/dL),C4(mg/L),C3(mg/L)indicators,SMN group and IMN There were significant differences between the AMN group and the AMN group(P<0.05),but there was no significant difference between the IMN group and the AMN group.In terms of age,the IMN group was significantly different from the SMN group and the AMN group(P<0.05).There were significant differences in serum PLA2 R antibody concentrations between the three groups of patients,and there was no significant difference between the IMN group and the AMN group(P>0.05).There were no significant differences in serum albumin,creatinine,uric acid,triglycerides and other three groups(P>0.05).6.Serum PLA2 R concentration in patients with idiopathic membranous nephropathy after 6 months of hormone combined with CTX treatment was statistically different from serum PLA2 R concentration in patients without remission.7.anti-PLA2 R antibody level is an independent factor affecting the remission of patients with IMN.Conclusion1.The positive rate of IMN anti-PLA2 R antibody is higher than that of SMN and AMN;2.There is a certain correlation between serum anti-PLA2 R antibody levels and disease activity in patients with IMN and AMN;3.Serum anti-PLA2 R antibody levels are independently associated with IMN prognosis;4.AMN patients are younger than IMN;5.Serum PLA2 R antibody levels distinguish between AMN and IMN.