穿通支原体感染与IgA肾病临床  

Association between Mycoplasma penetrans infection and clinicopathology of IgA nephropathy

作　　者：姜雪 许菲菲 章慧娣 章建娜 史艳玲 孙梅 

机构地区：[1]医学院附属第一医院肾内科,温州325000

出　　处：《中华肾脏病杂志》2011年第7期484-487,共4页Chinese Journal of Nephrology

摘　　要：目的研究穿通支原体（Mycoplasma penetrans，Mpe）感染与IgA肾病（IgAN）患者临床病理改变的关系。方法采集经病理检查确诊的IgAN患者118例、健康体检者89例和慢性肾脏病（CKD）90例的血液标本，用试剂盒方法提取血清DNA。用PCR技术检测Mpep35脂蛋白，对阳性标本采用Southern印迹方法进行验证。根据IgAN患者Mpe感染情况分为阳性组和阴性组，结合患者的临床病理资料进行分析。结果89例健康体检者中仅1例Mpep35脂蛋白为阳性，阳性率为1．1％。90例CKD患者中2例阳性，阳性率为2．2％。118例IgAN患者中19例阳性，阳性率为16．0％，显著高于健康组及CKD组，差异均有统计学意义（均P〈0．01）。Mpe阳性组42．1％患者临床表现为肉眼血尿，显著高于Mpe阴性组（P〈0．01）。Mpe阴性组24h尿蛋白量、Scr、Lee病理分级显著高于阳性组，差异均有统计学意义（均P〈0．05）。两组间肾小管、肾间质及肾血管积分差异无统计学意义。结论IgAN患者的Mpe检出率显著高于健康体检者和CKD患者。Mpe阳性患者更多表现为发作性肉眼血尿。Mpe感染可能与IgAN的发病有关。Objective To study the association between Mycoplasma penetrans （Mpe） infection and clinicopathology of IgA nephropathy （IgAN）. Methods Blood samples of 118 IgAN patients, 90 patients with chronic kidney disease （CKD） and 89 healthy people were collected. Mpe DNA in serum was detected by PCR and positive samples were confirmed by Southern blotting. According to Mpe infection, IgAN patients were divided into positive and negative groups. Association between clinicopatholgical features of IgAN and Mpe infection was examined. Results Significantly higher Mpe positive rate was found in IgAN group as compared to CKD and healthy groups （16.0% vs 2.2% and 1.1%, P〈0.01）. In Mpe positive group, 42.1% patients presented macroscopic hematuria, which was significantly higher than that in Mpe negative group （P〈0.01）. While Mpe negative group had greater proteinuria, higher serum creatinine level, higher Lee grading of pathology compared to Mpe positive group. There were no differences of tubnlointerstitial lesions and arteriole hypertrophy between two groups. Conclusions IgAN patients have higher Mpe infection rate than CKD patients and healthy people. Mpc positive IgAN patients have more macroscopic hematuria. Mpe infection may be associated with the pathogenesis of IgAN.

关 键 词：肾小球肾炎 IGA 穿通支原体 感染 

分 类 号：R692.3[医药卫生—泌尿科学]