Primary Study Of Shear Wave Elastography Combined With Serum Phospholipase A2 Receptor Antibody In The Diagnosis Of Membranous Nephropathy

Objective: 1.The aim of the study is to assess diagnostic value of Shear wave elastography(SWE)technique in different pathological types of membranous nephropathy(MN),and to compare the Young’s modus values(YM)of renal parenchyma in patients with idiopathic membranous nephropathy(IMN),secondary membranous nephropathy(SMN)and atypical membranous nephropathy(AMN).2.To detect the clinical and biochemical indexes of blood and urine and serum anti-M-type phospholipase A2 receptor antibody(PLA2R)titers of patients in different test groups,and to compare the differences of above laboratory indexes in patients with different pathological types.3.To investigate the diagnostic value of combined application of SWE and PLA2 R in different pathological types of membranous nephropathy.Methods: A total of 118 patients who had been performed with renal biopsy during June 2020 to January 2021 were enrolled in this study.Of all the subjects,78 cases(46 men and 32 women)had been proven MN confirmed by pathology,26 AMN,28 SMN and 24 IMN included.Thirty healthy volunteer were selected during the same period as control group.Young’s modulus of renal parenchyma was measured by SWE technique in the above four groups.The clinical and biochemical indexes of blood and urine and PLA2 R titer of MN patients were statistically analyzed,and the specificity and sensitivity of diagnosing MN patients were analyzed by combining YM value and PLA2 R value.Results: The YM value of renal parenchyma of patients with membranous nephropathy in all groups was higher than that of healthy group(P < 0.05),and the differences of renal parenchyma YM value among different pathological types of membranous nephropathy groups were also statistically significant(P < 0.05): SMN > AMN > IMN.According to the ROC curve,when the maximum area under the curve was 0.646,the cut-off point of Young’s modulus value YM was 26.0k Pa,and the area under the ROC curve of combined diagnosis of Young’s modulus value YM and PLA2 R was0.928.Conclusions: The renal elasticity of patients with membranous nephropathy is indeed different from that of healthy people,and the renal hardness of patients with different pathological types of membranous nephropathy is also different.SWE combined with serum anti-M-type phospholipase A2 receptor antibody can provide certain clinical value for non-invasive diagnosis of pathological types of membranous nephropathy.