摘要
目的分析免疫球蛋白(Ig)及补体C3水平对肾小球疾病临床诊断和鉴别诊断的意义。方法初治经肾活组织检查(活检)证实的肾小球疾病患者2 230例。分析患者Ig和(或)C3升高、降低的临床意义。结果①IgG、IgA和IgM三系均降低或某一克隆升高其余两个克隆降低者仅见于副蛋白血症肾损害。IgG与尿蛋白呈负相关;与其他肾疾病比较,狼疮性肾炎(LN)患者IgG浓度显著升高、C3降低(P<0.05);IgA肾病(IgAN)IgA浓度(3.43±1.31)g/L高于除紫瘢性肾炎(HSN)(3.22±1.31)g/L外其他肾疾病(P<0.05),其IgA/C3比值(95%CI=2.75～2.97)明显高于原发肾小球疾病患者(95%CI=0.92～2.46,均P<0.05)。结论免疫球蛋白三系(IgGI、gM和IgA)均降低或某一克隆升高其余2个克隆降低,提示副蛋白血症肾损害;IgG升高伴C3降低见于LN;IgA/C3比值>2.75提示IgAN的可能。
Objective To analyze the clinical significance of immune globulin and/or complement C3 level to renal glomerular disease diagnosis or differential diagnosis.Methods A total of 2 230 initial treatment renal glomerular disease patients who received renal biopsy were enrolled.We analyzed the clinical significance of immune globulin and complement C3 level change.Results ①The level of serum IgG,IgA,and IgM all lowered or one clone raised but other two clones lowered only in paraproteinmia renal damage patients.Serum IgG had negative correlation with urine protein.The levels of serum IgG or C3 in lupus nephritis patients were obviously higher or lower than those in other groups.The level of serum IgA（3.43±1.31） g/L in IgA nephropathy patients was higher than that in other kidney diseases except for HenochSchonlein purpura patients（P0.05）.The ratio IgA/C3（95%CI=2.75-2.97） in IgA nephropathy patients was obviously higher than that in primary renal glomerular disease patients（95%CI=0.92-2.46,P0.05）.Conclusion Serum IgG,IgM and IgA all lowered or one clone raises but other two clones lower,revealing paraproteinmia renal damage.Serum IgG increases and C3 decreases in lupus nephritis patients.The ratio IgA/C32.75 signifies the possibility of IgA nephropathy.
出处
《临床荟萃》
CAS
2010年第19期1669-1671,共3页
Clinical Focus
关键词
肾疾病
肾小球
免疫球蛋白类
补体C3
诊断
鉴别
kindney diseases
kidney glomerulus
immune globulins
complement C3
diagnosis
differential
