慢性肾炎患者血浆海蟾蜍毒素水平及其肾脏受体表达变化  

Changes of plasma marinobufagenin level and its receptor Na＋-K＋-ATPase expression in kidney of chronic glomerulonephritis patients

作　　者：陈净[1] 王玉[1] 田江 谢子建 李晓玫[1] 

机构地区：[1]北京大学第一医院肾内科北京大学肾脏病研究所,100034 [2]Department of Medicine and Pharmacology, University of Toledo, College of Medicine, Toledo, Ohio 43614,USA

出　　处：《中华肾脏病杂志》2010年第9期653-656,共4页Chinese Journal of Nephrology

摘　　要：目的 了解慢性肾小球肾炎（CGN）患者血浆海蟾蜍毒素（MBG）水平及其受体Na＋-K＋-ATP酶（NKA）在肾组织中的表达情况.方法 竞争抑制ELISA法测定28例CGN患者和14例健康人血浆MBG浓度.应用免疫荧光共聚焦、免疫组化和图像分析技术检测CGN患者肾组织内NKA的表达部位及表达量.结果 CGN患者血浆MBG浓度低于健康对照组[（0.579±0.214）nmol/L比（0.715±0.154）nmol/L,P＜0.05],其中高血压者与血压正常者血浆MBG浓度差异无统计学意义[（0.595±0.231）nmol/L比（0.557±0.197）nmol/L,P＞0.05].血浆MBG浓度与24 h尿钠排泄量无相关（r=-0.022,P＞0.05）.与正常肾组织比较,CGN患者近端肾小管NKA表达下降,肾小管NKA表达阳性面积百分比明显减少[2.1%（0.5%～6.2%）比5.6%（3.5%～10.8%）,P＜0.01],且与24 h尿钠排泄量呈正相关（r=0.551,P＜0.01）.结论 CGN患者血浆MBG水平及其受体NKA在近端肾小管表达的下降可能参与CGN患者钠代谢调节.Objective To investigate the change of plasma marinobufagenin （MBG） level and the expression of its receptor Na＋-K＋-ATPase （NKA） in renal biopsy specimens of chronic glomerulonephritis （CGN） patients. Methods Twenty-eight CGN patients and 14 healthy people were enrolled in the study. The plasma MBG concentration was measured by competitive inhibition ELISA system. Immunofluorescence and immunohistochemistry staining were applied to detect the expression of NKA in renal biopsy specimens of 28 CGN patients and analyzed by semi quantitively. Results Compared with healthy controls, CGN patients had significant lower plasma MBG concentration [（0.579±0.214） nmol/L vs （0.715±0.154） nmol/L, P〈0.05], without further significant difference between CGN patients with hypertension and with normal blood pressure [（0.595±0.231） nmol/L vs （0.557±0.197） nmol/L, P〉0.05]. Meanwhile, proximal tubular staining of NKA was decreased compared with normal controls. The NKA positive staining area of the CGN group was lower than that of normal controls [2.1% （0.5%-6.2%） vs 5.6% （3.5%-10.8%）, P〈0.01] and correlated with 24-hour urinary sodium excretion （r=0.551, P〈0.01）.Conclusion Decreased plasma MBG level and its receptor expression on proximal tubules may play a role in the regulation of sodium in CGN.

关 键 词：肾小球肾炎 慢性 海蟾蜍毒素 NA(+)K(+)交换ATP酶 

分 类 号：R692.3[医药卫生—泌尿科学]