糖尿病肾病患者单核细胞趋化蛋白-1与小管间质损害关系的研究  

Relationship of monocyte chemoattractant protein-1 with renal tubulointerstitial lesions in human diabetic nephropathy

作　　者：闫振成[1] 张建国[1] 黄志芳[1] 王惠明[1] 丁涵露[1] 李开龙[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所肾内科,重庆400042

出　　处：《第三军医大学学报》2004年第14期1291-1294,共4页Journal of Third Military Medical University

摘　　要：目的　探讨局部单核细胞趋化蛋白 1(MCP 1)表达和分泌与人糖尿病肾病 (DN)病变的关系。方法　采用免疫组化和原位杂交检测人DN肾组织MCP 1蛋白和mRNA表达 ,并用免疫组化检测CD68;尿液和血清MCP 1水平测定采用ELISA法。结果　DN肾小管间质MCP 1表达明显增高 (P <0 0 1) ,小管间质病变越重 ,MCP 1表达越高 (P <0 0 1)。DN肾小管间质CD68表达明显增高 (P <0 0 1) ,小管间质病变间差异明显 (P <0 0 1)。DN肾小球MCP 1、CD68表达较正常对照明显增高 (P <0 0 5 )。DN尿液MCP 1水平明显较正常对照组增高 (P <0 0 1) ,与间质纤维化密切相关 ,且与临床蛋白尿程度呈正相关。结论　DN患者肾组织内MCP 1表达与肾病变发生发展密切相关 ,尤其与肾小管间质病变的形成有关 ,这可能与MCP 1具有强烈趋化和激活单核 巨噬细胞而致肾小管间质损害有关 ,尿液MCP 1水平可能是反映肾小管间质病变程度的最佳指标之一。Objective To investigate the relationship of the local expression and production of monocyte chemoattractant protein 1(MCP 1) of patients with diabetic nephropathy (DN). Methods The MCP 1 protein and mRNA expressions were detected by immunohistochemical method and in situ hybridization. The CD68 expression was examined by immunohistochemical method. Urinary and serum MCP 1 levels were measured by enzyme linked immunosorbent assay. Results MCP 1 expression increased significantly in DN renal tubulointerstitium in a degree dependent manner ( P <0.01). Significantly increased expression of MCP 1 was also found in DN renal glomeruli ( P <0.05). The expression levels of MCP 1 and CD68 in DN renal glomeruli were significantly higher than those in the normal control ( P <0.05). Urinary level of MCP 1 in DN was significantly higher than that in the control, which was closely correlated with interstitial fibrosis and positively correlated with urinary levels of protein. Conclusion The expression of MCP 1 may be involved in the development of DN, especially in the formation of renal tubulointerstitial lesions possibly through monocyte/macrophage recruitment and activation. Urinary level of MCP 1 may be one of the best markers for the diagnosis of renal tubulointerstitial lesions.

关 键 词：糖尿病肾病 肾小管间质病变 单核细胞趋化蛋白-1 

分 类 号：R392.11[医药卫生—免疫学] R692.390[医药卫生—基础医学]