The Role Of THSD7A Expression In Renal Tissue In The Diagnosis Of Idiopathic Membranous Nephropathy And Its Correlation With TCM Syndromes

Objective:This study by immunofluorescence test membranous nephropathy(MN)in patients with renal biopsy in the 7 a type 1 platelet response protein(THSD7A)of the specific case,discuss THSD7 A significance in diagnosis of idiopathic membranous nephropathy and its correlation with TCM syndromes,provide theory support for the TCM syndrome objective.Methods:1.Patients diagnosed with nephrotic syndrome through renal biopsy and combined with clinical manifestations were divided into the idiopathic membranous nephropathy group(IMN group),secondary membranous nephropathy group(SMN group)and nephrotic syndrome group(control group)according to the etiology.General data and laboratory tests(creatinine,blood urea nitrogen,blood uric acid,serum albumin,d-dimer,24-hour urine protein quantification,triglycerides,cholesterol,blood complement C3,blood complement C4,urine microglobulin,esr)were collected.Judge and record TCM syndrome types.2.The expression of THSD7 A in renal tissue was detected by immunofluorescence assay.Results:(1)Comparison of differences in general information(age and gender):(1)There was no significant difference in age and gender composition among the three groups(P=0.49 > 0.05).Gender: Z=3.237,P=0.335 > 0.05).(2)The SMN between three common cases(Ⅴ with lupus nephritis,hepatitis b virus associated membranous nephropathy,tumor associated membranous nephropathy),age,gender differences between groups have no statistical significance(P > 0.05;Gender: Z=3.237,P=0.335 > 0.05).(3)Among all TCM syndromes: there were no statistically significant differences in age and gender composition among all TCM syndromes(age:P > 0.05;Gender: Z=4.985,P=0.173 > 0.05).(2)Comparison of laboratory test results:(1)Compared among the three groups,urea nitrogen(BUN)was significantly increased in the SMN group(P<0.05),d-dimer was significantly increased in the SMN group(P<0.05),and serum albumin(ALB)was higher in the SMN group and the control group than in the IMN group(P<0.05).There was no significant difference between the other laboratory results(P > 0.05).(2)Between negative and positive THSD7A: the 24-hour urine protein quantification(24h UPR)in the THSD7 A positive group was significantly higher than that in the THSD7 A negative group,and the difference was statistically significant(P < 0.05).It suggested that the 24-hour urine protein quantification might be positively correlated with THSD7 A positive.(3)TCM syndrome types:Total cholesterol(TCH): the syndrome of damp-heat accumulation and blood stasis was significantly higher than that of liver and kidney Yin deficiency(P< 0.05).D-dimer: the syndrome of damp-heat accumulation and blood stasis is significantly higher than that of spleen-kidney Yang deficiency(P < 0.05).24h UPR: the syndrome of damp-heat accumulation and blood stasis was significantly higher than that of liver-kidney Yin deficiency(P < 0.05).(3)Compare the differences in the expression quantity of THSD7A:(1)Eexpression of THSD7 A in renal tissues in the IMN group,SMN group and control group: compared with the IMN group,the positive detection rate of THSD7 A in SMN(control group)was significantly reduced,Z=2.814,P=0.005(Z=4.261,P=0.00).Compared with the control group,Z=0.881,P=1.00>0.05,the difference was not statistically significant,that is,there was no difference in the positive detection rate of THSD7 A between the SMN group and the control group.(2)TCM syndrome types:A.Compared with spleen-kidney Yang deficiency,the positive detection rate of THSD7 A in damp-heat accumulation syndrome(syndrome of blood stasis and liver-kidney Yin deficiency)was significantly reduced,Z=-6.253,P=0.00(Z=-6.414,P=0.00).Z=6.072,P=0.00).B.Comparison between damp-heat accumulation syndrome and syndrome of liver-kidney Yin deficiency(syndrome of liver-kidney Yin deficiency),Z=0.312,P=1.000>0.05(Z=0.00,P=1.000>0.05),the difference was not statistically significant,that is,there was no significant difference in the positive detection rate of THSD7 A between damp-heat accumulation syndrome and syndrome of liver-kidney Yin deficiency(syndrome of liver-kidney Yin deficiency).C.There was no significant difference in THSD7 A positive detection rate between syndrome of venous stasis and syndrome of liver-kidney Yin deficiency(Z=6.072,P=1.00>0.05).D.Combined with Band C,it can be seen that there is no significant difference in the positive detection rate of THSD7 A between damp-heat accumulation syndrome,blood stasis syndrome and liver-kidney Yin deficiency syndrome.Conclusion: 1.The positive expression of THSD7 A in IMN was significantly higher than that in SMN and control group,suggesting that THSD7 A may be a specific marker for IMN.2.The positive detection rate of THSD7 A in spleen-kidney Yang deficiency syndrome was significantly higher than that in liver-kidney Yin deficiency syndrome,vein stasis syndrome and damp-heat accumulation syndrome,suggesting that the positive THSD7 A in kidney tissue may be the objective index of spleen-kidney Yang deficiency syndrome.