关键词: 免疫球蛋白, 补体, 肾病, 病理学, 荧光

Abstract: Objective　To investigate the relationship of serum immunoglobulins （IgG， IgA）， complements（C3， C4）， albumin（Alb）， 24 h urinary protein， blood lipids[total cholesterol(TC) and triglyceride(TG)] with kidney pathology in patients with nephrosis.  Methods　A total of 251 patients with nephrosis were enrolled. The correlations of serum IgG， IgA， C3， C4 and glomerular mesangial cell proliferation score with Alb， 24 h urinary protein， TC， TG， and the scores of IgG， IgA and C3 immune fluorescence intensities were analyzed. There were IgA nephropathy（IgAN， 106 cases）， membranous nephropathy（MN， 19 cases）， focal segmental glomerulosclerosis（FSGS， 14 cases）， minimal change disease (MCD， 7 cases)， lupus nephritis（LN， 7 cases）， hepatitis B virus-associated glomerulonephritis（HBV-GN， 5 cases）， hypertensive renal damage（8 cases）and healthy controls（56 cases）. Their levels of IgG， IgA， C3 and C4 were compared. Results　Serum IgG， IgA and Alb were positively correlated with IgA and C3 immune fluorescence intensities（P＜0.05）. Serum C3 and C4 had positive correlation with TC and TG（P＜0.05）， and had negative correlation with IgG， IgA and C3 （P＜0.05）. The score of glomerular mesangial cell proliferation with serum IgA， TG and the immune fluorescence intensities of IgA and C3 showed a positive correlation（P＜0.05）， and it with serum C3 showed a negative correlation（P＜0.05）. Serum IgG level of MCD group was the lowest， and the comparison of MCD group with IgAN， FSGS， LN， HBV-GN， hypertensive renal damage and healthy control groups was statistically significant（P＜0.05）， but the comparison of MCD group with MN group was not statistically significant（P＞0.05）. Serum IgA level of IgAN group was the highest， and the comparison of IgAN group with MN， FSGS， MCD and healthy control groups was statistically significant（P＜0.05）， but the comparison of IgAN group with LN， HBV-GN， hypertensive renal damage groups was not statistically significant（P＞0.05）. Serum C3 and C4 levels of LN group was the lowest， and the comparison of LN group with the other groups was statistically significant（P＜0.01）. Conclusions　Immunoglobulins， complements， urinary protein， Alb， blood lipids for the diagnosis， treatment and prognosis assessment of kidney disease have important guiding significance. However， it has a lot of influencing factors， and the diagnosis and treatment of kidney disease can not only rely on the changes of one or several index levels， but also should refer to whether there are influencing factors， combined with more clinical indices and kidney pathology in making comprehensive judgments.

Key words: Immunoglobulin, Complement, Nephrosis, Pathology, Fluorescence