成纤维细胞生长因子-2检测在儿童微小病变型肾病中的意义  

The role of fibroblast browth factor-2 in children with minimal change nephrotic syndrome

作　　者：孙利[1] 徐虹[1] 张秀荣[1] 郭慕依[1] 

机构地区：[1]复旦大学附属儿科医院肾脏内科,复旦大学上海医学院,200032

出　　处：《中国实用儿科杂志》2005年第1期29-32,i002,共5页Chinese Journal of Practical Pediatrics

摘　　要：目的　观察成纤维细胞生长因子 2 (FGF 2 )在微小病变肾病患儿的肾组织、血和尿中的表达 ;探讨FGF 2的作用。方法　收集 1999年 6月至 2 0 0 3年 6月复旦大学附属儿科医院 5 0例微小病变型肾病 (MCNS)患儿的临床资料 ,用免疫组化法检测所有患儿肾组织中的FGF 2沉积 ,同时用酶联免疫吸附试验检测 2 0例MCNS患儿不同时点(发病期、缓解期、未缓解期和复发期 )的血、尿FGF 2质量浓度。结果　 (1)FGF 2的分布 :在MCNS患儿的肾组织中 ,FGF 2主要分布在肾小球足细胞和肾小管上皮细胞的胞浆中 ,且有不同程度的表达。 (2 )肾小球的FGF 2表达 :频复发组的肾小球FGF 2明显高于非频复发组 (P <0 0 0 1) ;肾小球FGF 2与尿液中的转铁蛋白 (TRF)、白蛋白 (Alb)和视黄醇结合蛋白 (RBP)呈正相关 (P <0 0 5 )。 (3)肾小管的FGF 2表达 :肾小管FGF 2与尿液中的TRF呈正相关 (P <0 0 0 1)。肾活检时尿液FGF 2的质量浓度与肾小管FGF 2呈正相关 (P <0 0 0 5 )。 (4)血、尿FGF 2的变化 :尿液FGF 2的质量浓度在缓解期明显低于初发期 ;复发期比初发期更高 ;未缓解期亦比初发期高 (P <0 0 5 )。血FGF 2质量浓度各期无明显差异。结论　MCNS患儿的肾组织中 ,FGF 2主要表达于肾小球足细胞和肾小管上皮细胞的胞浆中。肾小球FGFObjective To observe the expression of FGF 2 in kidney tissue,plasma and urine,and discuss the role of FGF 2 in minimal change nephritic syndrome.Methods 50 children with MCNS were collected.FGF 2 level in renal tissue was determined with immunohistochemistry assays.Serial plasma and urine samples were collected from 20 of 50 patients,during the initial phase,remission phase,non remission phase and recurrent phase of the disease.FGF 2 level in plasma and urine were determined with enzyme linked immunosorbent assays (ELISA).Results (1) In renal tissue of MCNS,FGF 2 was distributed in cytoplast of podocyte and renal tubule epithelia.(2) Glomerular FGF 2 level in frequent relapse group was higher than that of infrequent relapse group (P<0 001).Glomerular FGF 2 level was correlated with urinary excretion of transferring,albumin and retinol binding protein (P<0 05).(3) FGF 2 level of the tubule was correlated to urinary excretion of transferring (P<0 001).FGF 2 level of tubule was also related to coinstantaneous urinary FGF 2 excretion (P<0 005).(4) There was an acute decrease in urinary FGF 2 excretion during remission phase,which returned to higher level during recurrent phase.Furthermore,there was a progressive increase during non remission phase (P<0 05).Plasma FGF 2 concentrations had not obvious change.Conclusion FGF 2 expresses positively in MCNS,distributes in cytoplasm of podocyte and renal tubule epithelia.The glomerular FGF 2 level is correlated with the frequent recurrence of MCNS.Measurements of urinary FGF 2 excretion in patients with MCNS may be useful indices for calculating recurrence and monitoring course of the disease.

关 键 词：儿童 微小病变肾病 成纤维细胞生长因子-2(bFGF) 

分 类 号：R72[医药卫生—儿科]