IgA肾病患儿血小板源性生长因子-D及其β受体表达的临床意义  

Expression and clinical implication of platelet-derived growth factor-D and platelet-derived growth factor-β in childhood IgA nephropathy

作　　者：戎赞华[1] 王晨[1] 郝军[1] 段惠军[1] 

机构地区：[1]河北医科大学病理学教研室,石家庄050017

出　　处：《中国危重病急救医学》2008年第5期275-278,共4页Chinese Critical Care Medicine

基　　金：河北省自然科学基金资助项目（C2006000825）

摘　　要：目的探讨血小板源性生长因子-D（PDGF-D）及其β受体与各种IgA肾病患儿的临床关系及意义。方法47例IgA肾病患儿分为轻度增生组（13例）、局灶增生组（19例）、增生硬化组（15例），留取其血尿和肾活检标本；以13例健康查体儿童的血、尿标本以及13例非IgA肾病患儿的肾活检标本作为对照。应用酶联免疫吸附法（ELIsA）和免疫组化法检测PDGF-D、PDGF-B以及PDGF-β在血液、尿液及肾组织中的表达；同时检测各组24h尿蛋白定量、血浆白蛋白（Alb）、肉眼血尿程度以及血尿素氮（BuN）、肌酐（Cr）水平。结果IgA肾病患儿血、尿PDGF-D和PDGF-B表达水平均明显高于对照组，且随病理分级增高逐渐增加（P均〈0．01）；血、尿PDGF-D和PDGF-B水平分别与24h尿蛋白定量呈显著正相关（PDGF-D：r血=0．546，r尿=0．760；PDGF-B：r血=0．634，r尿=0．577，P均〈0．01），与血浆Alb水平呈显著负相关（PDGF-D：r血0．649，r尿=-0．528；PDGF-B：r血=0．613，r尿=0．531，P均〈0．01），与肉眼血尿程度及血BUN、Cr无相关关系。PDGF-D和PDGF-β在IgA肾病患儿肾组织中的表达明显高于对照组，且表达量随疾病的进展而增加（P均〈0．01）；PDGF-B只在局灶增生组和增生硬化组患儿肾组织中呈显著表达。结论PDGF-D可明显促进IgA肾病患儿系膜细胞增殖及肾间质纤维化程度；PDGF-D对反映IgA肾病的严重程度及评价预后可能比PDGF-B更敏感。Objective To investigate the clinical implication of platelet-derived growth factor （PDGF）-D and PDGF-β in IgA nephropathy in childhood. Methods Forty-seven children with IgA nephropathy and 26 controls were enrolled for study, and their serum, urine and renal biopsy specimens were examined. The patients were divided into control group [including serum, urine specimens of 13 healthy children and 13 renal biopsy samples of non-IgA nephropathy in children], mild proliferation （MP） group （13 patients ）, focal proliferation （FP） group （19 patients ）, and proliferation sclerosis （PS） group （15 patients）. Enzyme-linked immunosorbent assay （ELISA） and immunohistochemistry were used to determine contents of PDGF-D, PDGF-β and PDGF-B in blood, urine and renal tissues. The levels of 24-hour urinary protein excretion, serum albumin （Alb）, serum blood urea nitrogen （BUN） and creatinine （Cr） were also determined. Results Compared with control group, levels of PDGF-D and PDGF-B were progressively elevated in blood and urine of IgA nephropathy children with increase in severity of glomerular damage （all P〈0.01）. Serum as well as urinary PDGF-D and PDGF-B levels were positively correlated with 24-hour urinary protein excretion （PDGF-D blood., r=0. 546, urine： r=0. 760; PDGF-B blood： r=0. 634, urine： r=0.577, respectively, P 〈0.01）, while negatively correlated with serum Alb levels in IgA nephropathy patients （PDGF-D blood： r=-0. 649, urine： r=-0. 528; PDGF-B blood： r=-0. 613, urine： r=-0. 531, respectively, P〈0. 01）. Contents of PDGF-D and PDGF-β in renal tissue were much higher than those of control group （P〈 0.01 ）. Along with the increase in severity of glomerular pathology, their contents increased gradually. PDGF-B was only significantly expressed in renal tissue in FP group and PS group. Conclusion PDGF-D might significantly enhance the development of mesangial proliferation and tubulointerstitial fibrosis. In comparsion with PDGF-B, PDGF-

关 键 词：IGA肾病 血小板源性生长因子 儿童 

分 类 号：R726.9[医药卫生—儿科]