Serum Phospholipase A2 Resistant Receptor Antibodies In The Diagnosis Of Idiopathic Membranous Nephropathy And Curative Effect Observation Of Immunosuppressive Therapy

Objective: To explore serum phospholipase A2 receptor antibody resistance the value of the diagnosis of idiopathic membranous nephropathy and TAC compared to CTX treatment the curative effect of IMN.Methods: Collection between April 2015 and November 2016 in the first affiliated hospital of xinjiang medical university department of nephropathy,at the same time line renal biopsy and serum anti PLA2 R antibodies detection of 282 cases of patients,use the indicators such as sensitivity,specific degrees,Kappa coefficient analysis of serum anti PLA2 R antibody levels correlated with histopathological diagnosis of renal biopsy.And for the treatment of the TAC and the IMN patients treated by CTX,regular monitoring of 24 h urine protein,serum albumin,quantitative indices such as white blood cells,renal function,blood lipid,remission rate of patients during treatment and so on.Results:1)At the same time of renal biopsy and serum anti PLA2 R antibodies detection of 282 cases of patients,the number of men more than women(men= 149,women=133,52.8%,47.2%);Number of han Chinese more than ethnic minorities(the han nationality in 162 cases,81 cases of Uygur,other ethnic 39 cases);Age distribution range is 14-72 years,mean age was(38.95 ±12.79).IMN group with the Non-IMN no statistical differences between gender and ethnicity,P > 0.05;2)Of 282 patients with renal biopsy,100 cases of pathological diagnosed with membranous nephropathy,among them,78 cases of PLA2 R antibody positive resistance,22 cases were negative,and the antibodies in renal biopsy in 182 patients diagnosed with Non-IMN,only 2 cases were positive.The sensitivity of the antibody detection IMN is 78.0%;The specific degree is 98.9%.Serum phospholipase A2 receptors(PLA2R)antibodies in the diagnosis of resistance of membranous nephropathy coincidence rate was 78.0%.3)Before the treatment,TAC and CTX group of 24 h urine protein quantitative,plasma albumin,blood leukocytes,renal function,blood lipids and other indicators of differences had no statistical significance(P > 0.05).Two groups after treatment for 3 months,6 months,24 h urine protein quantitative and plasma albumin levels significantly better than before treatment(P < 0.05).Treatment for 6 months,TAC group compared with CTX group,24 h urine protein quantitative low,plasma albumin is higher,differences were statistically significant(P < 0.05).4)Treatment for 6 months,the TAC group of partial remission rate and total remission rate is significantly higher than CTX group(P < 0.05).Conclusions: Serum anti-PLA2 R antibodies can be used as tumor-specific markers of IMN,can be used in the diagnosis of disease,diagnosis and treatment measure of potential.TAC and CTX treatment of IMN all have certain curative effect;The curative effect of treatment for 6 months,the curative effect and remission rate of TAC is more better than CTX.