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中文摘要：
目的确定血清低半乳糖化IgA1对鉴别诊断IgA肾病的临床价值。方法以原发性肾小球疾病患者91例为研究对象，接受肾活检并留取血清；以健康体检者20例血清作为对照。血清标本先用装有耦联蚕豆凝集素的微球进行微量离心柱法分离并洗脱，获得低半乳糖化IgA1。再以凝集素HAA（Helix aspersa）用ELISA法定量检测异常糖基化IgA1（HAA—IgA1）。分析血清低半乳糖IgA1升高在鉴别诊断IgA肾病方面的临床价值。结果48例IgA肾病患者HAA-IgA1水平[（83．7±41．0）U]高于健康对照组[（52．6±22．9）U]及43例其他原发性肾小球疾病患者组[（49．2±27．3）U]（均P〈0．01）。而该43例中，非IgA系膜增殖性肾炎患者22例（51％）的HAA—IgA1水平[（47．6±21．5）U]亦显著低于IgA肾病患者。以肾穿刺病理诊断为金标准，所绘制ROC曲线面积为0．797，面积的标准误为0．047（P〈0．01）；鉴别诊断IgA肾病的灵敏度为72．9％，特异度为72．1％，准确度为72．5％。结论应用微量离心柱法联合ELISA法检测IgA肾病患者血清低半乳糖IgAl对于鉴别诊断IgA肾病具有一定临床价值。
英文摘要：
Objective To evaluate the clinical value of detecting serum underglycosylated IgA1 in diagnosis and differentiation of IgA nephropathy （IgAN）. Methods Serum underglycosylated IgA1 was isolated by microspincolumn coupled with vicia villosa lectin （VVL） from 48 cases with IgAN and 43 cases with other primary glomerulonephritis. All the patients were diagnosed by renal biopsy. Sera from 20 healthy persons were used as control group. After isolation, the eluant with rich underglycosylated IgA1 was detected by incubation with biotinlabeled horseradish peroxidase （HRP） and Helix aspersa （HAA, recognizing N-acetylgalactosamine specifically）in enzyme-linked immunosorbent assay （ELISA）. The sensitivity and specificity of diagnosis and differentiation of IgAN with elevated serum underglycosylated IgA1 were analyzed. Results The level of serum underglycosylated IgA1 in IgAN patients [（83.7 ±41.0） U] was significantly higher than that in healthy control group [（52.6±22.9） U] and the patients with other primary glomerular diseases[（49.2±27.3） U] （all P〈0.01）. Twenty-two cases of non-IgA mesangial proliferative glomerulonephritis accounted for 51% of other primary glomerular disease, whose underglycosylated IgA1 level [（47.6±21.5） U] （all P〈0.01） was significantly lower as compared to IgAN patients. Taking the renal biopsy diagnosis as golden diagnostic criteria, the ROC curve was performed. The area under the curve was 0.797 with a standard error 0.047 （P〈0.01）. The sensitivity as a diagnostic test was 72.9%, with specificity 72.1% and accuracy 72.5%. Conclusion Detection of serum underglycosylated IgA1 level by microspincolumn method and ELISA assay has certain clinical value in diagnosis and differentiation of IgAN.
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