多种细胞因子在IgAN小管间质中作用及相关性研究  

The function of cytokines and relevant research in renal tubule and interstitial of IgA nephropathy

作　　者：张书韬[1] 佟丹丹[2] 张磊[2] 

机构地区：[1]黑龙江省公安厅刑事技术处 [2]哈尔滨医科大学病理学教研室,黑龙江哈尔滨150081

出　　处：《哈尔滨医科大学学报》2008年第1期18-21,共4页Journal of Harbin Medical University

基　　金：黑龙江省科技厅归国留学基金(Lc02c21);黑龙江省科技厅青年基金(Qc05c49)

摘　　要：目的探讨7种细胞因子在IgAN(IgA nephropathy)小管间质中的作用以及与IgAN小管间质损伤的相关性。方法经光镜、免疫荧光和电镜诊断为IgAN的肾活检组织86例,采用Katafuchi半定量积分标准和免疫组织化学技术,对86例IgAN进行了病理学分级和检测TGFβ1、TGFβ2、BMP-7、CTGF、bFGF、ICAM-1、PDGF等7种细胞因子的表达。结果①IgAN间质增生及炎细胞浸润达51.16%及82.56%;肾小管肿胀及小动脉壁增厚达41.86%、39.53%及39.53%;肾小球的系膜细胞不同程度的增生占50%;②TGFβ1,TGFβ2,BMP-7在IgAN肾组织中表达率最高;其次为bFGF,CTGF;再次为ICAM-1,PDGF;③细胞因子主要表达在肾小管、炎细胞浸润区域以及肾小管的系膜区。结论IgAN小管间质的损伤程度早于或重于肾小球的损伤。TGFβ1、TGFβ2、BMP-7、CTGF、bFGF可作为判断IgAN进展和预后的重要检测指标。Objective To study the function of cytokines in renal tubule and interstitial of IgA nephropathy （IgAN） .Methods Eighty-six cases of renal tissue were diagnosed as IgAN through light microscope, immuno fluorenscence and electron microscop. These cases were pathologically graded according to Katafuchi semiquantitation integrate index. Seven kinds of cytokine （TGFβ1, TGFβ2, BMP-7, CTGF, bFGF, ICAM-1, PDGF） were detected with immunohistochemical method. Results （1） Interstitial hyperplasia and inflammatory infiltration were observed in 51.16% and 82.56% of the cases. Renal tubule swelling and the thickness of arteriolar wall were observed in 41.86% ,39.53% and 39.53% of the cases. Proliferation of glomerular mesangial cells was observed in 50% of the cases;（2）The expression rate of TGFβ1 ,TGFβ2, BMP-7 in IgAN was the highest. The expression rate of bFGF, CTGF was moderately high. The least expressed were ICAM-1, PDGF; （3）These cytokines were expressed in renal tubule, inflammatory infiltration and glomenalar mesangial regions. Conclusion The injury degree of renal tubules and interstitial of IgAN is earlier and heavier than that of glomerulus. TGFβ1, TGFβ2, BMP-7, CTGF, bFGF could be used as important prognostic indicators for IgAN.

关 键 词：IGAN 细胞因子 肾小管间质损伤 预后 

分 类 号：R446.8[医药卫生—诊断学] R692.6[医药卫生—临床医学]