摘要
目的:探讨抗磷脂酶A2受体(PLA2R)抗体、幽门螺杆菌(Helicobacter pylori,Hp)和中医证型在特发性膜性肾病(idiopathic membranous nephropathy,IMN)患者的临床特点。方法:收集57例IMN患者的抗PLA2R抗体、Hp检测、中医证型分布的临床资料,进行数据处理和分析。结果:57例IMN患者的中医证型分别为肺肾气虚证、脾肾气虚证、脾肾阳虚证、肝肾阴虚证;其中脾肾气虚证可见于IMN的不同病理分期;在肺肾气虚证、脾肾气虚证、脾肾阳虚证、肝肾阴虚证的患者中,抗PLA2R抗体阳性率分别为73.7%、72%、75%、80%;在膜性肾病(MN)Ⅱ期、MN Ⅲ期患者中,抗PLA2R抗体阳性率分别为77.3%,70%;在肺肾气虚证、脾肾气虚证、脾肾阳虚证的患者中,Hp阳性率分别为63.2%、68%、75%;在MN Ⅱ期、MN Ⅲ期患者中Hp阳性率分别为63.6%、60%。结论:脾肾气虚证是IMN的主要中医证型;抗PLA2R抗体阳性可见于IMN的不同病理分期和各个中医证型;抗PLA2R抗体阳性率随着中医证型的演变而升高,抗PLA2R抗体检测联合中医证型可进行IMN的病情评估;HP阳性率在IMN不同病理分期阶段及不同的中医证型中均较高,且HP感染率随中医证型演变有明显升高趋势,在IMN的中西医治疗过程中需提高对抗Hp治疗地位重要性的认识。
Objective:To explore the clinical characteristics of anti-phospholipase A2 receptor(PLA2R)antibodies,Helicobacter pylori(Hp)and TCM syndrome types in patients with idiopathic membranous nephropathy(IMN).Methods:Clinical data on anti-PLA2R antibodies,Hp detection,and TCM syndrome distribution of 57 IMN patients were collected,and data processing and analysis were performed.Results:The TCM syndrome types of 57 patients with IMN were lung and kidney qi deficiency syndrome,spleen and kidney Qi deficiency syndrome,spleen and kidney yang deficiency syndrome,and liver and kidney yin deficiency syndrome.Among them,spleen and kidney Qi deficiency syndrome could be found in different pathological stages of IMN;in lung and kidney syndrome,Among patients with Qi deficiency syndrome,spleen and kidney Qi deficiency syndrome,spleen and kidney Yang deficiency syndrome,and liver and kidney Yin deficiency syndrome,the positive rates of anti-PLA2R antibodies were 73.7%,72%,75%,and 80%respectively;membranous nephropathy(MN)Ⅱ Among patients with stage 1 and MN stage Ⅲ,the positive rates of anti-PLA2R antibodies were 77.3% and 70% respectively;among patients with lung and kidney Qi deficiency syndrome,spleen and kidney Qi deficiency syndrome,and spleen and kidney Yang deficiency syndrome,the Hp positive rates were 63.2%and 68%,respectively.%,75%;the Hp positive rates in patients with MN stage Ⅱ and MN stage Ⅲ were 63.6% and 60%respectively.Conclusion:Spleen and kidney Qi deficiency syndrome is the main TCM syndrome type of IMN;anti-PLA2R antibody positivity can be seen in different pathological stages of IMN and various TCM syndrome types;the positive rate of anti-PLA2R antibodies increases with the evolution of TCM syndrome types,and anti-PLA2R antibody positivity increases with the evolution of TCM syndrome types.Testing combined with TCM syndrome types can be used to evaluate the condition of IMN;the HP positive rate is higher in different pathological stages of IMN and different TCM syndrome types,and the HP infection rate
作者
吕芳
范吉辉
易茹
孙文军
纪杨
LYU Fang;FAN Jihui;YI Ru;SUN Wenjun;JI Yang(Huaibei People’s Hospital of Anhui Province,Anhui Huaibei 235000,China)
出处
《中医药临床杂志》
2024年第5期924-929,共6页
Clinical Journal of Traditional Chinese Medicine
基金
安徽省淮北市科技计划项目(编号:rj201805)。
关键词
特发性膜性肾病
抗磷脂酶A2受体抗体
幽门螺杆菌
病理分期
中医证型
Idiopathic membranous nephropathy
Anti-phospholipase A2 receptor antibody
Helicobacter pylori
Pathological staging
Traditional Chinese medicine syndrome types
