IgA肾病患者扁桃体Bla细胞和IgAl阳性细胞表达及相关因素分析  

Expression of Bla cells and IgA1 positive cells in tonsil of IgA nephropathy patients andanalysis of associated clinicopathological factors

作　　者：侯启迪[1] 伍刚[1] 彭佑铭[1] 刘虹[1] 刘映红[1] 许向青[1] 姜文玲[1] 刘伏友[1] 

机构地区：[1]中南大学肾病研究所湘雅二医院肾内科,长沙41001l

出　　处：《中华肾脏病杂志》2011年第7期475-478,共4页Chinese Journal of Nephrology

摘　　要：目的研究Bla和IgAl阳性细胞在IgA肾病患者扁桃体中的表达及Bla细胞与血尿、蛋白尿和病理Lee分级的关系。方法肾活检确诊为原发性IgA。肾病及非肾炎慢性扁桃体炎患者各8例为对象，用免疫荧光法和激光共聚焦显微镜对其扁桃体组织进行Bla及IgAl细胞定位和定量计算，并按蛋白尿程度和Lee分级标准与IgA肾病组Bla细胞数量行统计学分析。结果Bla细胞主要分布在扁桃体生发中心和小结帽；IgAl细胞主要分布在上皮内、上皮下，以上皮和淋巴组织交界区为多。与慢性扁桃体炎组比较，IgA肾病组两种细胞表达明显增多（P〈0．01），且呈正相关（r=0．778，P=0．023）。在血尿伴蛋白尿和Lee≥m级组Bla细胞显著高于单纯血尿和Lee〈11I级组（P〈0．05）。结论IgA肾病患者扁桃体中IgAl可能是Bla细胞分泌的。Bla细胞数量随着患者蛋白尿的出现和病理严重程度的加重而增加，可能在疾病发生和进展过程中起着重要的作用。Objective To examine the expression of IgA1 and Bla positive cells in palatine tonsils of IgA nephropathy （IgAN） patients, and to analyze the association between Bla cells and elinicopathological changes. Methods Eight patients diagnosed as IgAN by renal biopsy and 8 chronic tonsillitis patients without nephritis as control were enrolled in the study. Immunofluorescence and laser scanning eonfocal microscope （LSCM） were applied to observe the localization and quantitative calculation of Bla and IgA1 positive cells. Statistic analysis of the association of Bla cells with proteinuria and pathological Lee＇s grading was performed. Results Bla cells were mainly localized in germinal center of tonsil, and IgA1 positive cells were mainly localized in subepithelium of tonsil. Compared to control group, the percent of Bla cells and IgA1 positive cells was significantly higher in IgAN （P〈0.01）. There was a positive correlation between Bla cells and IgA1 cells （P〈0.05）. In IgAN, the percent of Bla cells in patients with hematuria and proteinuria was obviously higher than that of patients with hematuria only （P〈0.05）. The number of Bla cells in IgAN patients with≥Lee＇s grade Ⅲ was significantly higher than that of those 〈 grade Ⅲ （P〈0.05）. Conclusions IgA1 may be secreted by Bla cells in the tonsil of IgAN patients. The number of Bla cells is correlated with exacerbation of proteinuria and pathological severity, which may play an important role in pathogenesis of IgAN.

关 键 词：肾小球肾炎 IGA Bla细胞 免疫球蛋白A1 

分 类 号：R692.3[医药卫生—泌尿科学]