Clinical value of serum PLA2R and IgG4 complexes in diagnosis of idiopathic membranous nephropathy
Objective To investigate the clinical value of simultaneous detection of serum PLA2R and IgG4 in the diag-nosis of idiopathic membranous nephropathy IMN.Methods From February 2020 to February 2021,115 MN patients were diagnosed by renal biopsy.According to the results of renal biopsy,the patients were divided into IMN(n=72)and SMN groups(n=43).In addition,30 cases of health personnel were selected as control group.Serum creatinine level,24 h urine protein quantification,plasma albumin level and glomerular filtration rate were measured by automatic chemiluminescence immunoanalyzer.The positive rate of anti PLA2R antibody,serum anti PLA2R and IgG4 level of the three groups were detected by ELISA method.The diagnosis vaule of PLA2R,IgG4 and combined detection was ana-lysed by ROC curve.Results A Automated chemiluminescence immunoassay results showed that the plasma albumin concentration and glomerular filtration rate in patients of the IMN and SMN groups were significantly lower than those of the control group,and the differences were statistically significant(P＜0.05).ELISA results showed compared with the SMN group and the control group,the positive percentage of anti-PLA2R antibodies in serum and the levels of anti-PLA2R and IgG4 in serum in the IMN group had statistically significant differences(P＜0.05).ROC curve analysis showed the AUC of PLA2R and IgG4 for the diagnosis of IMN patients were 0.879 and 0.844 respectively,both of which were accurate;for diagnostic sensitivity and specificity,PLA2R was 91.7％and 74.0％respectively;IgG4 was 91.7％and 71.2％respectively.The levels of PLA2R and IgG4 were included in the logistic regression model to calculate the comprehensive detection value.The AUC for the combined diagnosis of these two items was 0.903,and the sensitivity and specificity were 87.5％and 89.0％respectively,indicating a relatively high diagnostic value.Conclusion Serum PLA2R and IgG4 have high diagnostic value in idiopathic membranous nephropathy,and combined detection can im-prove diagnostic accuracy,which is worthy of clinical promotion.
Idiopathic membranous nephropathyM phospholipase A2 receptorimmunoglobulin G subgroup 4com-bined detectionclinical diagnostic value
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