IgA肾病足细胞损伤与肾小管间质病变临床病理相关研究  

Correlation between glomerular podocyte lesion and tubulointerstitial lesion in IgA nephropathy

作　　者：张丽萍[1] 谭会斌[1] 刑玲玲[1] 李绍梅[1] 王建荣[1] 杨万霞[1] 杨林[1] 傅淑霞[1] 

机构地区：[1]河北医科大学第二医院肾内科,河北石家庄050000

出　　处：《中国现代医学杂志》2010年第17期2662-2664,2668,共4页China Journal of Modern Medicine

基　　金：河北省科技厅资助课题(No:07276101D-15)

摘　　要：目的探讨肾小管间质损害在IgA肾病足细胞损伤中的意义。方法 45例IgA肾病患者根据Banff分级半定量进行分组,采用免疫组织化学法,检测各组肾组织足细胞表面特异性标记物Wilms'肿瘤蛋白(WT1)及转化生长因子(TGF-β1)的表达变化,并和患者尿β2-微球蛋白(β2-MG)水平进行比较。结果 IgA肾病患者肾组织TGF-β1表达与肾小球系膜的增殖程度、肾小球硬化程度呈正相关,且随着肾小管间质病变逐渐加重,肾组织WT1表达减少越明显,肾小管间质TGF-β1表达及尿β2-MG活性水平也越高,差异具有统计学意义(P<0.01)。结论改善肾小管间质损害可能成为治疗IgA肾病足细胞损伤的一个新途径。Objective To investigate the role of tubulointerstitial lesion in glomerular podocyte lesion in IgA nephropathy.MethodsForty-five patients diagnosed as primary IgA nephropathy by renal histology were involved.Tubulointerstitial lesion（TIL） was classified by using Banff scale.The expression of WT1 and TGF-β1 in renal tissue was detected by immunohistochemistry and compared with the urine level of β2-MG detected by RIA.ResultsThe expression of TGF-β1 in renal tissue of IgA nephropathy patients was positively associated with mesangial proliferation and glomerulosclerosis.With the progress of TIL in IgA nephropathy,WT1 expression markedly decreased,TGF-β1 expression in renal tissue and β2-MG in urine increased significantly（P 0.05）.ConclusionThese results suggest ameliorating tubulointerstitial lesion may be a new pathway of treating glomerular podocyte lesion in IgA nephropathy.

关 键 词：IGA肾病 足细胞 转化生长因子 

分 类 号：R586[医药卫生—内分泌]