To Explore The Clinical Significance Of Serum And Urine Anti-PLA2RAb In Idiopathic Membranous Nephropathy

Objective: To analyze the relationship between urine anti-PLA2 R antibody(uPLA2R-Ab),serum anti-PLA2 R antibody(sPLA2R-Ab)and clinical data in patients with idiopathic membranous nephropathy(IMN),and to explore the clinical significance of uPLA2R-Ab and sPLA2R-Ab in idiopathic membranous nephropathyMethods: 113 patients with membranous nephropathy diagnosed by clinical and renal biopsy in our hospital from September 2018 to January 2019 were selected.including 87 patients with idiopathic membranous nephropathy and 26 patients with secondary membranous nephropathy.There were 21 cases of Hepatitis B virus-related MN,and 5 cases of Membranous lupus nephritis.The all subjects were sent uPLA2R-Ab and sPLA2R-Ab by Enzyme-linked immunofluorescence assay(ELISA),And collected the general information of the patients used sort the data into the EXCEL-2003 database,to analyze the data used the statistical software SPSS22,the measurement data of each group of experimental data is expressed as mean ± standard deviation,the count data was expressed as a percentage,according to Whether the normal distribution is consistent with the t test or the rank sum test.Results:1.In the group of IMN with SMN in gender,age,Serum albumin,24-hour urine protein,glomerular filtration rate(estimated glomerular filtration rate,eGFR),sPLA2R-Ab,P>0.05,no statistical significance.Compared with IMN and SMN,uPLA2R-Ab had statistical significance(P<0.05).2.The sensitivity and specificity of sPLA2R-Abb in the diagnosis of IMN were 64.37% and 64.58%.The sensitivity and specificity of uPLA2R-Ab in the diagnosis of IMN were 57.47% and 92.50%.respectively,The sensitivity and specificity of sPLA2R-Ab combined with uPLA2R-Ab for diagnosing IMN were 83.91% and 78.51%.3.According to the results of sPLA2R-Ab and uPLA2R-Ab,the patients were divided into four groups.The criteria for determining the results were < 14RU/ml: negative.≥ 14RU/ml: Positive.According to this criterion,IMN was divided into group A with sPLA2R-Ab and uPLA2R-Ab positive,group B with sPLA2R-Ab positive and uPLA2R-Ab negative,group C with PLA2R-Ab negative and uPLA2R-Ab positive,and group D with sPLA2R-Ab and uPLA2R-Ab negative.There were differences in serum albumin,24-hour urinary protein,creatinine and urine PCX among the four groups.Serum albumin: group A < group C < group B < group D,24-hour urinary protein: group A > group C > group B > group D,urine PCX: group A > group C > group B > group D.There was no difference in eGFR among the four groups.4.In the IMN group,uPLA2R-Ab /eGFR was used for correlation analysis with serum albumin,24 h urine protein and PCX titer.Correlation analysis showed that uPLA2R-Ab /eGFR was negatively correlated with serum albumin(r=-0.174,P=0.010),positively correlated with 24-hour urine protein(r= 0.156,P=0.048),and positively correlated with urine PCX titer(r=0.123,P= 0.038),was not associated with sPLA2R-Ab.5.In the IMN group,sPLA2R-Ab was correlated with serum albumin,24 h urine protein,and PCX titer.Correlation analysis showed that sPLA2R-Ab was negatively correlated with serum albumin(r=-0.347,P=0.001),an positively correlated with 24-hour urine protein(r=0.292,P=0.017),positively correlated with PCX(r=0.243,P=0.019),and was statistically significant,and was not associated with eGFR.Conclusions:1.Different types of membranous nephropathy can not be identified only by sPLA2R-Ab.For patients with sPLA2R-Ab positive,it is necessary to further exclude the secondary factors of membranous nephropathy2.Combined detection of uPLA2R-Ab and sPLA2R-Ab can reduce the missed diagnosis of PLA2R-related Idiopathic membranous nephropathy.3.sPLA2R-Ab and uPLA2R-Ab are correlated with the activity of IMN membranous nephropathy.