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目的了解急进性肾炎(RPGN)中抗肾小球基底膜(GBM)抗体的发生率及其临床意义。方法自行制备可溶性人GBM抗原,应用酶联免疫吸附方法(ELISA)对29例RPGN患者进行抗GBM抗体的检测,并对阳性血清用免疫印迹法进行鉴定、验证。结果 29例RPGN患者中5例抗GBM抗体阳性,占17%,其中一例伴ANCA阳性。免疫印迹法证实均识别23-27KD,40-54KD的蛋白条带。3/4例免疫荧光呈现免疫复合物细颗粒样沿GBM沉积。结论抗GBM抗体型RPGN在我国并不少见,用ELISA法检测抗GBM抗体特异性高而且较间接免疫荧光方法(IIF)更灵敏。应早期对所有RPGN患者进行常规抗GBM抗体检测。
Objective To investigate the incidence of anti-glomerular basement membrane (GBM) antibody in patients with acute nephritis (RPGN) and its clinical significance. Methods Soluble human GBM antigens were prepared by ourselves. The anti - GBM antibodies were detected in 29 patients with RPGN by enzyme - linked immunosorbent assay (ELISA). The positive serum was identified and verified by immunoblotting. Results Among the 29 patients with RPGN, 5 were anti-GBM antibodies, accounting for 17%. One of them was associated with ANCA. Western blot confirmed that 23-27KD, 40-54KD protein bands were identified. Three-quarters of immunofluorescence presented immune complex-like fine particles deposited along the GBM. Conclusion Anti-GBM antibody RPGN is not uncommon in our country. The anti-GBM antibody was more specific by ELISA and more sensitive than indirect immunofluorescence (IIF). All anti-GBM antibodies should be routinely tested on all patients with RPGN.