摘要目的:探讨1型血小板反应蛋白7A域(THSD7A)在特发性膜性肾病(IMN)诊断中的价值。方法:在PubMed、Embase、CNKI、万方、VIP数据库中检索2014年1月到2019年6月发表关于THSD7A的中英文文献。严格按照制定的纳入和排除标准筛选文献，采用纽卡斯尔渥太华质量评估量表(NOS量表)评价文献质量。采用RevMan 5.3软件进行单个率的Meta分析，根据检测方法、种族及样本量进行亚组分析。通过依次剔除一篇文献来进行敏感性分析，绘制漏斗图检验文献发表偏倚。结果:共筛选出18篇文献，纳入IMN患者6097例。THSD7A在纳入的IMN患者中阳性率为4%(95% CI：3%~5%)，在M型磷脂酶A2受体(PLA2R)阴性的IMN患者中阳性率为8%(95% CI：6%~11%)。亚组分析结果提示血清抗体与肾组织抗原、高加索人与东亚人、样本量<100例与样本量≥100例分组间IMN患者THSD7A的阳性率比较，差异无统计学意义( P>0.05)。 结论:THSD7A在IMN患者中阳性率为4%，并且在PLA2R阴性患者中显著升高。THSD7A对诊断PLA2R阴性的IMN患者具有重要的临床价值。

abstractsObjective:To evaluate the diagnostic value of thrombospondin typel domain-containing 7A(THSD7A )for the diagnosis of idiopathic membranous nephropathy (IMN).Methods:By searching the databases of PubMed, Embase, CNKI, Wanfang and VIP from January 2014 to May 2019, all the literatures referred to THSD7A in both English and Chinese were reviewed and selected according to the inclusion and exclusion criteria. The quality was evaluated by using the Newcastle-Ottawa quality assessment scale. A Meta-analysis of single rate was conducted by the statistical software of RevMan 5.3. Subgroup analysis was performed according to the detecting method, race and sample size of THSD7A. Sensitivity analysis was performed by reducing a paper in order, and publication bias was tested by funnel plot.Results:A total of 18 essays involving 6097 IMN patients were included in this Meta-analysis. The positive rate of THSD7A was 4% (95 CI: 3%-5%) in the IMN patients and 8% (95% CI: 6%-11%) in the M-type phospholipase A2 receptor(PLA2R)-negative IMN patients. Subgroup analysis showed that there was no significant difference in the positive rate of THSD7A between serum antibody and renal tissue antigen, Caucasian and East Asian, sample size less than 100 and more than 100 IMN patients. Conclusions:The positive rate of THSD7A was 4% in IMN patients and significantly increased in PLA2R-negative patients. THSD7A has important clinical value in the diagnosis of PLA2R-negative IMN patients.