| Objective:To collect the clinical and biochemical data in patients with Idiopathic Membranous Nephropathy(IMN),Minimal Change Disease(MCD)and Ig A nephropathy(Ig AN),and explore the clinical significance of Urine Ig G4 in Idiopathic Membranous Nephropathy.Methods:We selected 82 patients including 44 patients with IMN,20 patients with MCD and 18 patients with Ig AN before they are adopted immunosuppressive therapy in our hospital from October 2019 to January 2020.All the patients were diagnosed by renal biopsy.Concentration of the Urine Ig G4 was detected by Enzyme-linked immunofluorescence assay(ELISA).All the clinical data were analyzed by the software SPSS23.Results:1.The average age of the group of IMN was higer than the groups of MCD and Ig AN(P<0.05).All the three groups revealed the male patients were more than female patients,but the difference was no statistical significance(P>0.05).Futhermore,there was no difference in the aspect of smoking rate in these groups.2.The concentration of the u-Ig G4 was respenctively(392.91±212.29)ng/ml、(216.05±89.06)ng/ml and(264.67±104.64)ng/ml in the group of IMN,MCD and Ig AN.The concentration of u-Ig G4 in the group of IMN was higher than the other groups(P<0.01).Compared with the group of IMN,the level of the proteinuria and e GFR was lower,but the level of the plasma albumin and the serum creatinine was higer in the group of Ig AN(P<0.01 or <0.05);The level of CHOL,LDL,TG in the patients of MCD was higer than IMN(P<0.05).3.For pathological types of IMN,the stage of Ⅰperiod owned higher age and lower e GFR(P<0.05).However,there wasn’t diffenrence in the clinical data,such as the gender,u-Ig G4,proteinuria,serum creatinine,urea nitrogen and blood lipid level in different pathological periods.4.According to the level of proteinuria,these patients of IMN were divided into three groups.The low-risk group included the patients whose the level of proteinuria were lower than 4g/d.The high-risk group included that the level of proteinuria were higher than 8g/d.And the others were in the middle-risk group.The concentration of the u-Ig G4 was respenctively(310.88±140.52)ng/ml、(418.61±242.40)ng/ml、(405.19±192.97)ng/ml,but the difference of the level of u-Ig G4 hadn’t statistical significance(P>0.05).5.The level of u-Ig G4 hadn’t difference between male and female with IMN.6.According to the age,these patients of IMN were divided into young group(≤44 years old)and middle-aged group(>44 years old).The young group owned the higher e GFR(P<0.01).The concentration of the u-Ig G4 was respenctively(427.50±262.28)ng/ml、(376.77±187.45)ng/ml.Nevertheless,the clinical data hadn’t statistical significance(P>0.05).7.Correlation anaysis revealed that the urine Ig G was positively correlated with serum Ig G(r=0.374,P=0.007).Meanwhile,u-Ig G4/e GFR was positively correlated with serum creatinine(r=0.500,P=0.000)and serum urea nitrogen(r=0.330,P=0.014),but negatively correlated with e GFR(r=-0.437,P=0.002).Conclusions:1.u-Ig G4 is valuable to the diagnosis of IMN.2.The level of u-Ig G4 can response the degree of injury of renal function,but can’t response the degree of pathological injury of idiopathic membranous nephropathy. |
PDF Full Text Request