血尿Ⅳ型胶原对肾组织纤维化的诊断价值  

Diagnostic value of serum type Ⅳ collagen in renal fibrosis

作　　者：司博林[1] 王晓明[1] 申瑞芳[1] 

机构地区：[1]江苏大学附属医院肾内科,江苏镇江212001

出　　处：《临床荟萃》2005年第19期1093-1095,共3页Clinical Focus

摘　　要：目的探讨血清、尿中Ⅳ型胶原浓度对肾组织纤维化的诊断价值。方法接受肾活检的25例肾脏病患者,分为3组,无纤维化组8例,肾小球硬化组6例,肾间质纤维化组11例;此外,未接受肾活检的慢性肾衰组患者8例;采用免疫组化技术检测肾组织Ⅳ型胶原的表达情况;用放免法测血清Ⅳ型胶原浓度。结果肾小球硬化组、肾间质纤维化组和慢性肾衰组血清Ⅳ型胶原浓度明显高于无纤维化组(P<0.05),血清Ⅳ型胶原与肾组织中Ⅳ型胶原及病变肾小管肾间质比率、肾小球硬化比率呈显著正相关(P<0.05);肾小球硬化组和肾间质纤维化组尿中Ⅳ型胶原浓度较无纤维化组明显增高(P<0.05),但慢性肾衰组尿Ⅳ型胶原浓度反而低于肾间质纤维化组。结论在排除肾外脏器纤维化的前提下,血清Ⅳ型胶原可作为判断慢性肾脏患者肾组织纤维化的无创性检查指标,尤其适用于有肾活检禁忌证的患者。Objective To elucidate the diagnostic value ot serum and urinary type Ⅳ collagen concentration on the renal fibrosis. Methods Twenty-five renal disease patients who had received renal biopsy were divided into three groups： no fibrosis group, 8 cases; glomerulosclerosis group, 6 cases; interstitial fibrosis group, 11 cases. Other 8 patients who suffered from chronic renal failure （CRF） without renal biopsy were also observed. Expression of type collagen in the renal biopsy specimens was examined using immunohistochemical staining and computer image analysis system. The serum and urinary type Ⅳ collagen concentration in patients were measured by radioimmunoassay （RIA）. Results Serum type [V collagen concentration of patients in glomerulosclerosis group, interstitial fibrosis group and CRF group was significantly higher than that in no fibrosis group（ P〈0.05）. Serum concentration of type Ⅳ collagen significantly positively correlated wi：th the expression of tubulointerstitial injury （ P〈0.05 ）. The urinary type interstitial fibrosis group were significantly higher than ype IV collagen in kidney,the degree of glomerulosclerosis and IV collagen concentrations of glomerulosclerosis group and hose in no fibrosis group（ P〈0.05）. But the urinary type Ⅳ collagen concentration was lower than that in interstitial fibrosis group. Conclusion Sserum type Ⅳ collagen concentration could be used as diagnostic index for renal fibrosis on condition that other organ fibrosis could be excluded,especially for the patients with contraindications of kidney biopsy.

关 键 词：胶原 肾组织纤维化 诊断 

分 类 号：R692[医药卫生—泌尿科学]