| Objective: To detect the sensitivity and specificity of anti-PLA2 R antibody in uygur patients with membrnous nephropathy(MN),understand whether the serum PLA2 R antibody can be regard as the biomaker in uygur patients with membranous,then understand whether there are differents in the expression of anti-PLA2 R antibody between uygurs and other nationnalities.Method:collect the clinic datas of 29 MN and 29 non-MN in uygur which were diagnosed through renal puncture biopsy from November 2016 to May 2017.Definite the patients with MN as the test group,anther was the control group.In the control group,there are IgA nephropathy,minimal lesion,focal periodic glomerular sclerosis(FSGS)and mesangial proliferative glomerulonephritis.Take the limosis serum sample on the second day of patients in hospital at 8AM,-6 refrigerator,detect the serum anti-PLA2 R antibody quickly.General collected the clinical data and experimental data,draw the ROC curve,using the correlation factor analysis the relationship between different variables.Result:1.In the test group,there were 21 males and 8 females,the male and female radio was21:8,which average age was(38.14±13.26).In the control group,there were 15 males and 14 females,the male and female radio was 15:14,which average age was(39.34±11.01).Such as age,gender,serum albumin index difference was not statistically significant.2.In the test group,the creatine,serum albmin,ures nitrogen was respectively(78.21±31.25)umol/l,(23.72 9.90)g/l,(6.10 1.72)umol/l.While in the control group,the data was(111.31±80.79)umol/l,(28.45±10.47)g/l,(8.86±6.29)umol/l.Differences between creatine and BUN was statistically significant.Through correlation analysis,the blood urea nitrogen and serum anti PLA2 R antibodies were negative correlation,and the partial coefficient was-0.095(P=0.487),which means there were not significant correlation.The creatinine and serum anti PLA2 R antibodies were positive corrrelation,and the partial coefficient was 0.036(P=0.487),which means there were not significant correlation.3.The positive ratio of surem PLA2 R antibodies in MN group was 58.62%(N=17/29),while in non-MN group was 0(N=0/29).In the test group,there were 10 IgA nephropathy,7 Minimal lesion,3 Diabetic Nephropathy,5 mesangial proliferative glomerulonephritis,1 Mesangial capillaries glomerulonephritis,1 interstitial nephritis,1 crescent glomerulo-nephritis,1IgM nephropathy.Above the pathological type of non-membranous nephropathy by serum anti-PLA2 R antibody tests were negative,which suggeset tihat serum anti-PLA2 R antibodies had specificity in the detection of membranous nephropathy.4.The sensitivity and specificity of anti-PLA2 R antibody in uygur patients with membranous nephropathy were 58.62% and 100%,95%CI was [69.8-93.9].The positive predictive value and the negtive predictive value were 100% and 70.73%,which the coincidence rate was79.31%.5.In all of samples,there was one sample can be regarded as in a state of clinical complete remission.The 24 hours urinary protein of the orther 28 cases were positive,but the titer werereduced than former,which was regarded as in disease to alleviate or recovery,cause the loss of antibody sensitivity.6.In all these samaples,in there were 10 samples whose the 24 hours urinary protein > 3.5 g of the experimental group,of which 8 cases of anti-PLA2 R antibodies resistance strong positive,2 cases were negative.The rest of the 24 hours urinary protein of 19 cases were less than 3.5 g,of which 9 cases of patients with anti PLA2 R antibodies strong positive,remaining10 cases for antibody negative.In experimental group,the imbalance of the samples on whether the 24 hours urine protien was more than 3.5g may affect antibody sensitivity.Conclusion:1.The positive predictive value of anti-PLA2 R antibody in uygur patients with membranous nephropathy was 100%,and the negative predictive value and coincidence rate were 70.73%and 79.31%.2.Serum anti-PLA2 R antibodies can be used as a specfic biomarker in uygur membranous nephropathy.3.The sensitivity of serum anti-PLA2 R antibodies in uygur membranous nephropathy were low,while the specificity was very high,which may be different from orther nationnalities. |
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