肥胖相关性肾病肾组织中nephrin desmin WT1的表达  

Glomerular expression of nephrin,desmin,WT1 in patients with obesity-related glomerulonephropathy

作　　者：谭会斌[1] 傅淑霞[1] 杨林[1] 曾文[1] 李绍梅[1] 李素敏[1] 高志均[1] 路学文[1] 

机构地区：[1]河北医科大学第二医院肾内科,石家庄050000

出　　处：《中国实用内科杂志》2009年第1期65-67,70,共4页Chinese Journal of Practical Internal Medicine

基　　金：河北省2007年医学科学研究重点课题项目(07053)

摘　　要：目的研究肥胖相关性肾病患者肾小球足细胞病变,分析不同肾组织病理类型患者肾小球足细胞中neph-rin、desmin、WT1的表达和分布特征。方法收集2001—2008年河北医科大学第二医院肾内科收治的16例经肾穿刺活检明确诊断的肥胖相关性肾病患者资料,根据其肾脏病理分为肥胖相关性肾小球肥大症(O-GM)组11例,肥胖相关性局灶节段性肾小球硬化症(O-FSGS)组5例。对照组5例,为外科切除的且已诊断为肥胖的肾脏肿瘤标本的正常皮质组织。应用免疫组织化学方法检测足细胞特异标志物nephrin、desmin、WT1,同时结合临床及肾组织病理有关指标的进行多因素分析。结果nephrin、desmin、WT1在正常肾组织沿肾小球基底膜呈连续、线形分布。O-GM组nephrin、desmin、WT1的表达量降低,与对照组比较,差异无统计学意义,O-FSGS组nephrin、desmin、WT1的表达下降,呈点状、短线条状,较正常组织少,差异有统计学意义(P<0.05)。O-FSGS组足细胞计数少于O-GM组,差异有统计学意义(P<0.01),且足细胞融合、微绒毛化改变和肾小球硬化数明显增多(P<0.05)。结论肥胖相关性肾病患者早期即出现肾小球足细胞中nephrin、desmin、WT1的表达和分布减少,随着病变的加重,这种变化愈发明显。Objective To explore the relationship between markers of podocyte and renal histological changes as well as renal function in obesity-related glomerulonephropathy patients. Methods 16 cases of obesity-related glomerulonephropathy were enrolled, then divided into two groups according to their renal pathological changes ： 11 cases of obesity related glomerulomegaly（ O-GM group） and 5 cases of obesity related focal segmental glomerulosclerosis（ O-FSGS group）. 5 cases of normal renal cortical tissus from obestiy patients with renal tumors were collected as control group. Nephrin, desmin and WT1 were immunohistochemically dectected in all the renal samples from those cases enrolled, and their relationship with clinical and pathological indices were assessed. Results In control group, the distribution of nephrin, desmin, WT1 showed a linear pattern along glomerular basement membrane, obesity-associated glomerulomegaly revealed a similar pattern. obesity-associated FSGS, however, showed dotted or short linear patterns. The result showed that the number of podocyte in patients with clinical nephropathy was associated with the glomerular histological changes, patients with obesity：associated FSGS with glomerulomegaly lesion demonstrated much more podocyte loss than patients with obesity-associated glomerulomegaly （ P 〈 0. 01 ）. The frequencies of pseudocyst formation, foot process effacement, microvillus and glomerulosclerosis were markedly increased in patients with obesity-associated FSGS as compared to obesity-associated glomerulomegaly （ P 〈 0. 05 ）. Conclusion We concluded that the injury of podocyte was observed in the patients with obesity-related glomerulonephropathy, the expression of nephrin, desmin, WT1 decreases significantlly in obesity-associated FSGS.

关 键 词：肥胖相关性肾病 足细胞 NEPHRIN DESMIN WT1 

分 类 号：R5[医药卫生—内科学]