CAJ | 학술논문

目的：检测在成人特发性膜性肾病患者肾组织中M型磷脂酶A2受体1（PLA2R1）抗原的阳性率及其与特发性膜性肾病关系。方法选取经肾活检证实的108例肾小球疾病患者，其中包括41例特发性膜性肾病、2例乙型肝炎病毒相关性膜性肾病、8例V型狼疮肾炎、27例IgA肾病、19例微小病变性肾病、5例轻度系膜增生性肾小球肾炎和6例局灶节段性肾小球硬化。应用间接免疫荧光法检测患者肾组织中PLA2R1抗原。结果41例特发性膜性肾病患者中35例肾组织PLA2R1抗原阳性，阳性率为85.37%。其中PLA2R1沿着肾小球毛细血管襻呈细颗粒状沉积。在V型狼疮性肾炎、乙型肝炎病毒相关性膜性肾病及其他肾小球疾病肾组织中均未发现PLA2R1抗原沉积。特发性膜性肾病PLA2R1阳性患者与PLA2R1阴性患者相比较，年龄、血肌酐、血清白蛋白、24 h尿蛋白定量均无统计学差异（P>0.05）。结论在成人特发性膜性肾病患者肾组织中应用间接免疫荧光法证实PLA2R1抗原的阳性率为85.37%，PLA2R1阳性与阴性患者在临床表现上无统计学差异。
목적：검측재성인특발성막성신병환자신조직중M형린지매A2수체1（PLA2R1）항원적양성솔급기여특발성막성신병관계。방법선취경신활검증실적108례신소구질병환자，기중포괄41례특발성막성신병、2례을형간염병독상관성막성신병、8례V형랑창신염、27례IgA신병、19례미소병변성신병、5례경도계막증생성신소구신염화6례국조절단성신소구경화。응용간접면역형광법검측환자신조직중PLA2R1항원。결과41례특발성막성신병환자중35례신조직PLA2R1항원양성，양성솔위85.37%。기중PLA2R1연착신소구모세혈관반정세과립상침적。재V형랑창성신염、을형간염병독상관성막성신병급기타신소구질병신조직중균미발현PLA2R1항원침적。특발성막성신병PLA2R1양성환자여PLA2R1음성환자상비교，년령、혈기항、혈청백단백、24 h뇨단백정량균무통계학차이（P>0.05）。결론재성인특발성막성신병환자신조직중응용간접면역형광법증실PLA2R1항원적양성솔위85.37%，PLA2R1양성여음성환자재림상표현상무통계학차이。
Objective To investigate the prevalence of PLA2R1 in renal biopsy specimens of patients with idiopathic membranous nephropathy (IMN) and explore the relationship between PLA2R1 and IMN. Methods A total of 108 adult patients with biopsy-proved glomerular diseases were enrolled in this study, including 41 with IMN, 2 with hepatitis B-associated membranous nephropathy, 8 with V lupus nephritis, 27 with IgA nephropathy, 19 with minimal change nephropathy, 5 with mild mesangial proliferative glomerulonephritis, and 6 with focal segmental glomeruloselerosis (FSGS). Indirect immunofluorescence assay was used to detect PLA2R1 in the biopsy specimens and the clinical variables of the IMN patients were analyzed. Results In 35 of the 41 (85.37%) patients with IMN, PLA2R1 was detected with a fine granular pattern in the subepithelial deposits along the glomerular capillary loops. PLA2R1 antigen was not detected in patients with other glomerulopathies. No significant differences were found in age, serum creatinine, serum albumin, or 24-h urinary protein level between PLA2R1-positive and negative patients with IMN (P>0.05). Conclusion According to our results, 85.37% of adult patients with biopsy-proven IMN are positive for PLA2R1 antigen, which, however, does not contribute to variations of the patients' clinical manifestations.