肥大细胞、巨噬细胞及转化生长因子在IgA肾病患者肾组织中的浸润及意义  

Infiltration and significance of mast cells,macrophages and the expression of transforming growth factor beta 1 in renal tissue of patients with IgA nephropathy

作　　者：刘雪梅[1] 马瑞霞[1] 朱月华[1] 赵秀珍[1] 刘丽秋[1] 

机构地区：[1]青岛大学医学院附属医院肾内科,山东省青岛市266003

出　　处：《中国组织工程研究与临床康复》2007年第8期1485-1488,I0003,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：山东省卫生厅资助课题(2005HZ022)~~

摘　　要：目的:观察肥大细胞、巨噬细胞、转化生长因子β1在IgA肾病患者肾组织中的浸润表达,并分析其意义。方法:①收集2004-06/2006-02青岛大学医学院附属医院肾内科收治的26例IgA肾病住院患者的肾活检标本,均经肾活检确诊肾小球系膜区存在以IgA为主的免疫复合物,并经临床及实验室检查排除紫癜性肾炎、狼疮性肾炎等继发性IgA肾病,临床资料及病理资料完整,患者全部签署肾穿刺知情同意书。另取5例配型不合的移植肾或肾穿刺后病理结果正常的肾组织(捐献者均签署捐献协议)作为正常对照组。②两组标本均行常规组织化学染色及特染,采用免疫组织化学技术检测肥大细胞、巨噬细胞在肾组织中的浸润及转化生长因子β1的表达,肥大细胞与巨噬细胞阳性呈黄褐色,转化生长因子β1阳性呈深黄色。③IgA肾病活动性指标包括每系膜区系膜细胞增生数、间质炎性细胞浸润细胞性新月体占肾小球面积的百分比3项。慢性化指标包括纤维性新月体占肾小球面积、局灶性节段性硬化占肾小球面积、肾小管萎缩占肾小管间质面积、间质纤维化程度占肾小管间质面积4项。④单盲法分析肥大细胞、巨噬细胞及转化生长因子β1的相关性及其与IgA肾病活动性指标、慢性化指标、血肌酐、尿蛋白之间的关系。结果:①肥大细胞、巨噬细胞的浸润及转化生长因子β1的表达:正常肾组织中偶见或无肥大细胞、巨噬细胞和转化生长因子β1的表达,而患肾中肥大细胞、巨噬细胞的浸润数量和转化生长因子β1的表达均明显增强(t=3.82～7.27,P<0.01)。②肥大细胞、巨噬细胞、转化生长因子β1与临床指标的相关性:相应部位肥大细胞、巨噬细胞的浸润数量及转化生长因子β1的表达呈显著正相关(r=0.51～0.91,P均<0.01)。肥大细胞数量与慢性化指标、血肌酐呈显著正相关(r=0.87,0.69,P均<0.01),与活动性指标和AIM： To observe the significance of infiltration of mast cells, macrophages and expression of transforming growth factor beta 1（TGF-β1） in renal tissue of patients with IgA nephropathy （IgAN）. METHODS：①Renal biopsy specimens from 26 patients with IgAN, who were hospitalized in Department of Nephrology, Affiliated Hospital of Medical College, Qingdao University from June 2004 to February 2006 were collected. All the patients were finally diagnosed having IgAN that was characterized by depositions of IgA in glomerular mesangial region by renal biopsy. And purpuric nephritis, lupus nephritis and other secondary IgAN were removed by clinical and laboratory examination. Their clinical and pathological data are complete. They all signed informed consent before renal biopsy. Five normal controls included misfit zygosity donator＇s kidney and renal biopsy specimens with normal pathological results. ②Histochemical stain and specific toluidine blue stain were used for all renal biopsy specimens. The infiltration of mast cells, macrophage and expression of TGF-β1 in renal tissue of the two groups were detected with immunohistochemistry. Tryptase positive mast cells and CD68＋ macrophages displayed yellow brown; TGF-β1 positive region presented deep yellow. ③IgAN active indexes included mesangial cells number, interstitial inflammatory cell number, and percentage of glomerular cellular crescent. Chronic indexes included 4 items such as area percentage of fibrosis glomerular crescent, focal segmental sclerosis of the whole glomerulum, atrophia tubules of the whole tubulointerstitum, and interstitial fibrotic fields of the whole tubulointerstitium.④By single blind method, the relation among the number of mast cells, macrophages, and expression of TGF-β1, and their correlation with active index, chronic index, serum creatinine and albuminuria were analyzed. RESULTS： ①Infiltration of mast cells, macrophages and expression of TGF-β1： Mast cells, macrophage and expression of TGF-β1 were scarce

关 键 词：肾小球肾炎 IGA 肥大细胞 巨噬细胞 转化生长因子Β 

分 类 号：R692[医药卫生—泌尿科学]