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识别不同靶抗原的抗肾小球基底膜抗体与临床表型相关 被引量:4
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作者 崔昭 贾晓玉 +6 位作者 刘畅 赵娟 杨瑞 曲贞 郑欣 刘章锁 赵明辉 《中国血液净化》 2010年第3期147-151,共5页
目的研究识别不同靶抗原的抗肾小球基底膜(glomerular basement membrane,GBM)抗体与临床表型的关系。方法应用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA),以重组人a1、a2、a3、a4和a5(IV)NC1为固相抗原,测定97例抗GBM... 目的研究识别不同靶抗原的抗肾小球基底膜(glomerular basement membrane,GBM)抗体与临床表型的关系。方法应用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA),以重组人a1、a2、a3、a4和a5(IV)NC1为固相抗原,测定97例抗GBM病患者血清中抗体的靶抗原,并分析其与临床病理表现的关系。69例患者血清进一步应用以正常人肾组织为底物的间接免疫荧光法(indirect immunofluorescence,IIF)检测抗体识别的抗原表位的位置。隐匿性抗原表位的暴露采用6M尿素对组织切片进行预处理,天然暴露抗原表位的检测则以未经处理的组织切片作为底物。结果所有患者血清均识别a3(IV)NC1,56.7%患者同时识别a1(IV)NC1,43.3%患者识别a2(IV)NC1,53.6%患者识别a4(IV)NC1,85.6%患者识别a5(IV)NC1。抗a3(IV)NC1抗体的水平是患者确诊时的血肌酐水平(r=0.308,P=0.003)以及肾脏病理肾小球中新月体的比例(r=0.492,P<0.05)的独立决定因素。识别a5(IV)NC1的患者血清对天然暴露的抗原表位的识别率较高(67.3%比30.0%,P=0.026),且抗a5(IV)NC1抗体的水平与细胞性新月体的比例呈正相关(P=0.013)。合并抗中性粒细胞胞浆抗体(antineutrophil cy-toplasmic antibodies,ANCA)阳性的患者,对a1(IV)NC1(7.3%比26.2%,P=0.011)和a4(IV)NC1(7.7%比24.4%,P=0.023)的识别率较低。结论抗GBM抗体的主要靶抗原位于a3(IV)NC1,其抗体的水平是肾脏损害程度的决定因素。天然暴露的抗原表位可能与a5(IV)NC1相关,其抗体在疾病的发病机制中可能发挥重要作用。合并ANCA阳性的患者,其抗体识别的靶抗原较少。 展开更多
关键词 抗肾小球基底膜病 goodpasture 自身抗体 靶抗原 临床表型
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Goodpasture syndrome and hemorrhage after renal biopsy: A case report 被引量:2
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作者 Wei-Long Li Xi Wang +6 位作者 Shu-Yuan Zhang Zi-Gan Xu Ying-Wei Zhang Xing Wei Chun-Di Li Ping Zeng Shao-Dong Luan 《World Journal of Clinical Cases》 SCIE 2020年第2期404-409,共6页
BACKGROUND Goodpasture syndrome(GS) is a rare disease, the morbidity of which is estimated to be 0.5-0.8 per million per year. Hemorrhage is the most serious complication in renal biopsy. Despite the fact that both GS... BACKGROUND Goodpasture syndrome(GS) is a rare disease, the morbidity of which is estimated to be 0.5-0.8 per million per year. Hemorrhage is the most serious complication in renal biopsy. Despite the fact that both GS and hemorrhage after renal biopsy are rare, it has not been reported that they are likely to occur in the same patient.CASE SUMMARY A 30-year-old man with diffuse pulmonary hemorrhage and rapid progressive renal function caused by anti-glomerular basement membrane disease presented atypical symptoms without hemoptysis, accompanied by life-threatening hypoxemia. Plasmapheresis was performed, and glucocorticoids and cyclophosphamide were administered. The patient started to show signs of improvement. Percutaneous renal biopsy is an appropriate diagnostic measure that is commonly safe, but this patient experienced hemorrhage after operation,thus necessitating embolization of the renal artery to stop the bleeding. The patient’s condition was improved, and the serum anti-glomerular basement membrane antibody level was 106 AU/m L(normal range: < 24 AU/m L) and slowly decreased. His discharge medications were oral daily prednisone(30 mg)and continued maintenance hemodialysis.CONCLUSION GS is a rare organ-specific autoimmune disease that is invariably ubiquitous in the lung and kidney areas. Renal biopsy is the appropriate procedure for the treatment of GS disease, although it is an invasive measure. 展开更多
关键词 goodpasture disease Anti-glomerular basement membrane disease Renal biopsy HEMORRHAGE Glomerular basement membrane Case report
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114例抗肾小球基底膜抗体阳性结果分析 被引量:5
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作者 李丽娟 李晓梅 曾彩虹 《检验医学与临床》 CAS 2018年第21期3186-3190,共5页
目的探讨抗肾小球基底膜(GBM)抗体检测在抗GBM疾病及其他不同疾病中的应用。方法回顾分析经间接免疫荧光(IIF)法及酶联免疫吸附试验(ELISA)检测血清抗GBM抗体均为阳性的患者114例,比较抗GBM抗体在抗GBM疾病及其他疾病中的分布和抗体滴... 目的探讨抗肾小球基底膜(GBM)抗体检测在抗GBM疾病及其他不同疾病中的应用。方法回顾分析经间接免疫荧光(IIF)法及酶联免疫吸附试验(ELISA)检测血清抗GBM抗体均为阳性的患者114例,比较抗GBM抗体在抗GBM疾病及其他疾病中的分布和抗体滴度差异,探讨其与临床表现及病理间的联系。结果 114例抗GBM抗体阳性患者,包括抗GBM疾病99例(86.84%),其中抗GBM肾炎65例(57.02%)、Goodpasture综合征26例(22.81%)、抗GBM肾炎合并其他肾病8例(7.02%);非抗GBM相关疾病15例(13.16%)。Goodpasture综合征患者的男性、有机溶剂/工业粉尘暴露、咯血、合并少尿或无尿比例高于其他疾病组(P=0.022、0.014、0.001、0.001),抗GBM肾炎的吸烟比例小于其他组(P=0.006),抗GBM肾炎和Goodpasture综合征患者合并中性粒细胞细胞质抗体(ANCA)的比例小于抗GBM肾炎合并其他肾病和非抗GBM相关疾病组(P=0.014)。抗GBM疾病患者血肌酐、抗GBM抗体水平、合并新月体病例及新月体比例均高于非抗GBM相关疾病组(均P=0.001)。99例抗GBM疾病患者,抗GBM抗体水平与性别、年龄、合并咯血无关,与少尿或无尿、确诊时患者肌酐水平、肾小球中新月体比例呈正相关,与合并ANCA呈负相关。结论抗GBM抗体阳性主要见于抗GBM疾病中,特别是抗GBM抗体水平较高的患者,临床医生需及早诊断及鉴别诊断抗GBM疾病,及早治疗,改善预后。 展开更多
关键词 抗肾小球基底膜抗体 抗肾小球基底膜疾病 goodpasture综合征
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