The correlation between the level of PLA 2R and the condition and prognosis of patients with primary membranous nephropathy / 中国医师杂志

ABSTRACT

Objective:To investigate the correlation between serum anti phospholipase A2 receptor (PLA 2R) antibody level and the condition and prognosis of patients with primary membranous nephropathy (PMN).Methods:61 patients who were diagnosed as PMN in the laboratory department of Jiangsu Province Hospital of Chinese Medicine from January 2017 to August 2019 were selected and divided into PLA 2R positive group (41 cases) and PLA 2R negative group (20 cases) according to the level of PLA 2R antibody. The gender, age and other general data of the two groups were collected, and the clinical pathological characteristics and prognosis of the two groups were analyzed. Spearman correlation was used to analyze the correlation between the level of PLA 2R antibody and the disease condition and treatment prognosis.Results:The levels of estimate glomerular filtration rate (eGFR), total protein (TP) and albumin (ALB) in PLA 2R positive group were lower than those in PLA 2R negative group, while the levels of 24-h urinary protein and IgG4 were higher in PLA 2R positive group than that in PLA 2R negative group ( P<0.05); Multivariate logistic regression analysis showed that 24-hour urinary protein was an independent risk factor for PLA 2R antibody level ( OR=2.242, P<0.05), while TP and ALB levels were protective factors ( OR=0.840, 0.674, P<0.05); The patients in both groups were followed up for one year by rechecking serological indexes. The complete remission rate and total remission rate of PLA 2R positive group were lower than those of PLA 2R negative group ( P<0.05); Spearman correlation analysis showed that the level of PLA 2R antibody was negatively correlated with the levels of TP, ALB, and prognosis of patients ( r=-0.642, -0.547, -0.357, P<0.05), and positively correlated with the level of 24-hour urinary protein ( r=0.347, P<0.05). PLA 2R in renal tissue of 61 patients was found to be positive in 63.93% (39/61). Conclusions:The level of PLA 2R antibody is closely related to serum albumin, TP, 24 h urinary protein and prognosis of patients with PMN.