IgA肾病患者肾小管中P-gp表达与肾脏病理及肾功能损害的相关性  

The effects of renal tubular P-gp expression on pathological lesion and renal function in IgA nephropathy

作　　者：杨汝春[1] 王永钧[1] 鲁盈[1] 厉春萍[1] 朱晓玲[1] 

机构地区：[1]杭州市中医院肾病实验室,310007

出　　处：《浙江医学》2011年第10期1453-1455,共3页Zhejiang Medical Journal

基　　金：浙江省科技计划项目（2005C33030）

摘　　要：目的通过对IgA肾病肾小管中P-糖蛋白（P-glycoprotein，P-gp）表达与肾脏病理损害相关性的研究，探讨肾小管功能及其损伤在IgA肾病进展中的作用的关系。方法以经肾活检诊断的188例原发性IgA肾病患者为研究对象。肾活检前检查患者24h尿蛋白（24hUP）、肌酐清除率（Ccr）、血肌（Scr）、尿素氮（BuN）等。肾脏病理损害主要参考Lee分级、Katafuchi半定量积分标准和Andreoli病理活动性／慢性指数评分标准。采用免疫组化方法测定肾组织中P-gP表达，统计分析肾小管P-gP蛋白表达与肾脏病理损害积分以及患者肾功能的相关性。结果IgA肾病肾小管中P-gP表达与肾脏病理损害Lee分级和Katafuchi半定量积分均呈显著负相关，P-gP与肾小管问质积分的相关系数明显大于与肾小球、肾血管等组织学积分的相关系数。肾小管中P-gP表达强度与Ccr呈显著正相关，与24hUP、Scr、BuN等呈显著负相关。结论IgA肾病患者P-gP介导的肾小管转运功能可能参与对肾功能的保护，减缓肾脏病理损害的进展。Objective To explore the effects of P-glycoprotein （P-gp） expression in renal tubules on renal pathological lesion and renal function in progression of IgA nephropathy （IgAN）. Methods One hungdred and eighty eight（188） patients with primary IgAN diagnosed by renal biopsy were studied. Clinical data, including age, sex; serum creatinine level （Scr）, creatinine clearance rate （Ccr）, 24h urinary excretion of protien（24hUP） and Blood urea nitrogen（BUN） were detected before renal biopsy. The assessment of renal pathological lesion was according to Lee SM and Katafuchi semiquantitative scoring system. Immunohistochemistry was performed to detect the expression of P-gp in nephridial tissue. The relationship between P-gp expressions and Scr, Ccr, 24hUP, BUN, or pathological lesion semiquantitative scores were analyzed. Results P-gp expression level in kidney of IgAN patients showed statistically significant negative correlations with Ccr, and significant negative correlations with 24hUP, Scr, BUN and pathological lesion semiquantitative scores. Conclusion P-gp expression and transport Mediated by P-gp possibly participate in protectinq renal function and preventing progression of kidney pathological iniurv.

关 键 词：IGA肾病 P-糖蛋白 肾脏病理 

分 类 号：R586[医药卫生—内分泌]