The Significance Of The Expression Of PLA2R In Renal Tissue On The Diagnosis Of Idiopathic Membranous Nephropathy And Its Correlation With TCM Syndrome Types

Objective:In this study,the expression of Phospholipase A2 receptor(PLA2R)was detected in renal tissue of patients with nephrotic syndrome(NS),and the significance of PLA2R on IMN and its relationship with TCM syndromes was investigated,which provides the evidence for the Clinical diagnosis and therapy of IMN.Methods:1.The patients with NS undergone biopsy were divided into IMN group,SMN group and control group(nephrotic syndrome other than membranous nephropathy)according to the etiological classification,and collected the renal perforation of each group 1-3 days of laboratory indicators and TCM four diagnostic data.According to the syndrome differentiation of traditional Chinese medicine,it can be divided into damp heat accumulation syndrome,syndrome of vein stasis syndrome,spleen-kidney yang deficiency syndrome and liver-kidney yin deficiency syndrome..2.The frozen section of renal tissue was used to detect the expression and distribution of PLA2R in renal tissue by immunofluorescence method.The expression of PLA2R in different groups of renal tissues was analyzed.And analyze the correlation between PLA2R and TCM syndrome types.Results:1.The age distribution:(1)Compared with the control group,the mean age at onset of disease in the control group was the lightest(36.15±11.89)years old in the IMN group and the SMN group.The average age of onset in the IMN group was the largest,with no significant difference between the age groups.P>0.05;(2)Compared with the TCM syndromes,the average age of the liver and kidney yin deficiency syndrome was the highest,which was(45.47±12.51)years old,the average age of disease of the dampness and heat accumulation syndrome,the syndrome of collateral circulation arrest and spleen-kidney yang deficiency syndrome.There was no significant difference.There was no statistically significant difference in the age composition between the syndromes(P>0.05).2.Gender distribution:Overall,the prevalence of males is more common than that of females,with the proportions of males and females being 59.68%and 40.32%respectively.The ratio of males to females is 1.48:1.(1)In IMN group,SMN group compared with the control group,gender composition between the three groups was not statistically significant(x~2=1.292,P=0.524>0.05).(2)There was no statistical difference in gender composition between the 4 groups of TCM syndrome(x~2=3.477,P=0.324>0.05).3.The comparison of laboratory indicators:(1)Comparison between IMN group,SMN group and control group:Urea nitrogen level in IMN group was significantly lower than that in SMN group;DMN level in SMN group was significantly higher than that in control group;the levels of blood complement C4 in IMNZ group and SMN group were significantly lower The control group,there are statistical differences(P<0.05).There was no significant difference between the other indicators(P>0.05);(2)Comparison between different syndromes:Total cholesterol in the syndromes of damp heat accumulation and phlegm stasis syndrome is higher than that in liver and kidney yin deficiency syndrome,and the 24-hour urinary protein quantification of damp-heat accumulation syndrome,venous stasis syndrome,and spleen-kidney yang deficiency syndrome Both were higher than the liver-kidney yin deficiency syndrome,and the differences were statistically significant(P<0.05).There was no significant difference between the other indicators(P>0.05).4.The positive rate of PLA2R in IMN group,SMN group and control group was 72.41%in IMN group,23.08%in SMN group,5%in control group,and significantly higher in IMN group than in IMN group The expression of PLA2R in the other two groups and the three groups was significantly different(x~2=24.388,P=0.000<0.01).5.The correlation between PLA2R and renal tissue in different TCM syndromes There was no relationship between PLA2R and renal tissue in different TCM syndromes(x~2=0.788,P=0.852>0.05).conclusion:1.The positive rate of PLA2R in renal tissue of IMN group was much higher than that of SMN group and control group,and there was a statistically significant difference.PLA2R was a specific biomarker of IMN and was helpful for the diagnosis and differential diagnosis of IMN.2.There is no relationship between TCM syndrome type and PLA2R in renal tissue.