糖尿病肾病患者肾组织中内皮素受体A和B表达的变化  

Alteration in the expression of endothelin receptor A and B in renal tissue of patients with diabetic nephropathy

作　　者：裴华颖[1] 张丽敏[1] 杨万霞[1] 王建荣[1] 杨林[1] 

机构地区：[1]河北医科大学第二医院肾病科,石家庄050000

出　　处：《中华糖尿病杂志》2015年第11期670-675,共6页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：河北省科技厅支撑计划项目（1127-6103D-8）;河北省卫生厅医学科学研究指令性课题（20090367）

摘　　要：目的探讨肾组织局部内皮素受体A和B（ETAR和ETBR）表达的变化在糖尿病肾病（DN）发展中的意义。方法选取2011年10月至2013年2月住院经肾病理确诊为2型糖尿病、DN患者28例，依据肾病理分型分为3组：DNI级组（s1，n=8），DNII级组（s2，n=10），DNm级组（s3，n=10）。来自肾肿瘤患者病肾切除后远离肾肿瘤的正常肾组织作为对照组（c，n=5）。应用免疫荧光双染法定位ETAR、ETBR在肾组织的分布部位，免疫组化法检测其表达并进行半定量分析，计算肾小球硬化率，收集患者相关临床资料。并行方差分析、q检验和相关分析。结果（1）DN患者男性13例，女性15例，平均年龄（51±10）岁，各组间年龄、血压、血肌酐和白蛋白差异无统计学意义，24h尿蛋白定量随DN加重逐渐升高，组间有显著差异。（2）ETAR和ETBR主要在近端肾小管表达，在肾小球有极少量表达。（3）对照组肾组织内ETAR表达少于ETBR。随着病情加重，DN患者肾组织中ETAR表达逐渐增多，组间差异均有统计学意义（F=194．78，P〈0．05）。（4）ETAR／ETBR比值在各组间分别为c组0．370±0．021，S1组0．830±0．188，S2组1．230±0．093，S3组2．110±0．142，各组间差异有统计学意义（F=249．21，P〈0．05）。f5）ETAR的表达及ETAR／ETBR比值与患者病程、尿蛋白定量和肾小球硬化率呈正相关（r=0．522～0．833，均P〈0．05）。结论肾组织局部ETAR、ETBR表达明显增加、ETAR／ETBR比值倒置与DN进展相关，与DN病变严重程度呈正相关。Objective To investigate altered expression of two endothelin receptor subtypes, e.g. endothelin A- and B-receptors （ETAR and ETBR）, in local renal tissue of patients with type 2 diabetic nephropathy （DN） with progression of diabetic nephropathy. Methods Twenty eight inpatients with type 2 diabetes mellitus（T2DM） who had biopsy-confirmed DN from October 2011 to February 2013 were divided into 3 groups by pathologic classification： DN I grade （group S1, n=8）, DN 11 grade （group S2, n=10） and DN m grade （group S3, n=10）. The normal renal tissue apart from kidney tumor was collected from patients with kidney tumor as control group （group C, n=5）. Double-labeling imnmnofluorescence was used to detect the distribution of ETAR and ETBR receptors. Semi-quantitative analysis of the expression in renal tissue was performed with immunohistochemistry. The rate of glomerulosclerosis was calculated, too. Data were anaylzed using ANOVA, correlation and q test. Result （1） Mean age of patients with DN （including 13 male and 15 female） was （51±10） years old. No statistical difference in age, blood pressure, serum creatinine and albumin was observed among groups. Significant difference was observed in 24-hour proteinuria, which increased with the progression of DN. （2） The majority of ETAR and ETBR was expressed in the proximal tubular and few in glomrular. （3） The expression of ETAR was lower than that of ETBR in control group. The expression of ETAR progressively increased with DN aggravation. Statistical difference was observed among the groups （F-194.78, P〈0.05）. （4）The ratio of ETAR/ETBR in group C was 0.370±0.021, group S1 0.830±0.188, group S2 1.230±0.093, group s3 2.110±0.142, respectively; There were statistical significance among groups （F=249.21, P〈0.05）. （5） The expression of ETAR and the ratio of ETAR/ETBR had a significant positive correlation with the course of disease, urine protein and the rate of glomerular sclerosis （r=0.522- 0.833, all

关 键 词：糖尿病 2型 糖尿病肾病 内皮素受体 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]