| Purpose:The purpose of this study was to study the value of serum phospholipase A2 receptor antibody in the diagnosis of primary membranous nephropathy,and to explore the correlation between the titer level of phospholipase receptor antibody and the TCM syndrome type,clinical and pathological characteristics of idiopathic membranous nephropathy,so as to provide new ideas for clinical diagnosis and treatment.Methods:Study subjects: from December 2017 to December 2019,the patients were first treated in the outpatient and ward of the department of nephrology of Shaanxi hospital of traditional Chinese medicine.The patients were diagnosed as primary membranous nephropathy by renal puncture biopsy,which met the standard of inclusion and exclude,and had complete data of the four diagnosis of traditional Chinese medicine,laboratory data and pathological data.Methods: the general clinical data,TCM syndrome types,laboratory indicators and pathological typing of patients with primary membranous nephropathy were retrospectively analyzed to study the correlation between serum phospholipase A2 receptor antibody titer level and TCM syndrome types,clinical and pathological typing.Results:1.A total of 120 cases were included in this study,with a positive phospholipase A2 receptor antibody rate of 58.33%.20 cases(16.67%)with high titer,50 cases(41.67%)with low titer,and 50 cases(41.67%)with negative titer.There were 67 males,accounting for 55.83%.53 cases were female,accounting for 44.17%.The ratio is 1.26:1.There was no significant difference in gender and age between the three groups(P > 0.05).2.In this study,the TCM syndrome type was mostly seen in spleen-kidney Yang deficiency,with 67 cases(55.83%).The age of patients with liver-kidney Yin deficiency was relatively high.3.The levels of blood albumin and blood IgG were lower and the levels of urea nitrogen were higher in the patients with damp heat accumulation type(P < 0.05).There was no significant statistical difference in hemoglobin,serum creatinine,serum C3,triglyceride and serum uric acid(P > 0.05).The titer level of damp heat accumulation type was higher,the type of liver and kidney Yin deficiency was lower,and there was no significant statistical difference between TCM syndrome type and titer level(P > 0.05).4.In this study,stage Ⅱ was the most common pathological classification,with 91 cases(75.83%),15 cases(12.5%)and 14 cases(11.67%)in stage Ⅲ.There was no significant difference in titer level between clinical and pathological types(P > 0.05).5.Serum phospholipase A2 receptor antibody titer level ofprimary membranous nephropathypatients was related to blood Ig G,24-hour urinary protein quantification and blood albumin,but was not significantly correlated with hemoglobin,cholesterol,C3 and uric acid(P > 0.05).6.The pathological types of different TCM syndromes were mostly seen in stage Ⅱ,and those with pathological types of stage I,Ⅱ and Ⅲ were mostly seen in spleen-kidney Yang deficiency.There was no significant statistical difference between TCM syndrome type and pathological type(P > 0.05).Conclusion:1.In this study,the positive rate of serum Anti-PLA2 R was 58.33%,indicating that Anti-PLA2 R detection is of certain significance for disease diagnosis.2.Among the patients included in this study,spleen-kidney Yang deficiency was the most common syndrome type,followed by liver-kidney Yin deficiency,and stage Ⅱ and I were the main pathological types.3.In patients with damp heat accumulation type,the antibody titer level is high,the blood albumin and blood IgG levels are low,the blood urea nitrogen level is high,and the clinical condition is serious.The antipyretic and moisture-reducing agents should be added when the hormones are combined with the immunosuppressive agents to improve the clinical efficacy.4.The level of antibody titer was related to blood IgG,24-hour urine protein ration and blood albumin. |
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