肾活检组织血管紧张素AT1、AT2和MAS受体表达与糖尿病肾病病理损伤的关系  

Expression of AT1, AT2 and MAS receptors in renal biopsy tissue from diabetic nephropathy patients and its relationship with pathological injury

作　　者：马也娉 张铮[2] 卓莉[2] 杨悦[2] 陈大鹏[2] 戴沛霖[2] 刘琳 高红梅[2] 邹古明[2] 李文歌[1,2] Ma Yeping1,2 , Zhang Zheng2, Zhuo Li2, et al.(1 Graduate School of Peking Union Medical College, Beijing 100730, China; 2 Department of Nephrology, China -Japan Friendship Hospital, Beijing 100029, Chin)

机构地区：[1]北京协和医学院研究生院,北京100730 [2]中日友好医院肾内科,北京100029

出　　处：《国际泌尿系统杂志》2018年第2期256-261,共6页International Journal of Urology and Nephrology

基　　金：国家自然科学基金（81170675,81200537）;北京市科委科技计划重大项目（D131100004713002,D171100002817003）

摘　　要：目的观察糖尿病。肾病（diabeticnephropathy，DN）肾活检组织中血管紧张素受体AT1、AT2和MAS受体表达情况，并探讨其与肾脏病理损伤的关系。方法选取2004年1月至2017年7月在中日友好医院肾内科行肾穿刺活检病理诊断为DN的患者124例，其中病理分型为I型＋Ⅱa型15例，Ⅱb型26例，Ⅲ型76例，Ⅳ型7例。使用免疫组化染色评估。肾活检组织中血管紧张素受体的表达情况。比较各型患者的临床资料和肾活检组织血管紧张素受体表达情况。结果在不同病理分型的患者中，与I＋Ⅱa型、Ⅱb型及Ⅳ型相比，Ⅲ型肾小球、肾小管AT1受体表达显著增加。随着病理损伤的加重，肾脏血管AT1受体表达减少。肾小球AT2受体表达在Ⅱb型最高，随着病理损伤的加重，表达减少。与I＋Ⅱa型、Ⅲ型及Ⅳ型相比，Ⅱb型肾小管AT2受体表达显著增加。肾小球MAS受体表达在I＋Ⅱa型最高，Ⅲ型与Ⅱb型无明显差异，Ⅳ型与Ⅲ型相比，表达下降。肾小管和肾脏血管MAS受体表达与肾小球基本一致。结论DN肾活检组织血管紧张素受体表达与肾脏病理改变存在一定的相关性，为深入认识肾素一血管紧张素系统（renin-angiotensinsystem，RAS）在DN中的作用提供了依据。Objective To observe the expression of ATI, AT2 and MAS receptors in renal biopsy tissue from diabetic nephropathy （DN） patients, and to discuss its relationship with renal pathological injury. Methods A total of 124 patients diagnosed as DN by renal biopsy in our hospital from January 2004 to July 2017 were enrolled in our research （ 15 cases of class I ＋ IIa, 26 cases of class IIb, 76 cases of class IIl and 7 cases of class IV）. The expression of angioteusin receptors was e- valuated by immunohistochemistry and analyzed by mean density. Clinical data, protein expression of AT1, AT2 and MAS receptors in renal biopsy tissue and its relationship with pathological injury were evaluated. Results Glomerular and tubular AT1 receptor expression in patients of class III was sig- nificantly stronger than class I ＋ IIa, IIb and IV. Vascular AT1 receptor expression gradually weakened as the pathological injury was aggravating. Glomerular AT2 receptors expression in patients of class IIb was strongest , glomerular AT2 receptors expression weakened as the pathological injury was aggravat- ing. Tubular AT2 receptors expression in patients of class IIb was significantly stronger than class I ＋ IIa, IlI and IV . Glomerular MAS receptor expression in patients of class I ＋ II was strongest , it was no difference between class IIb and III, glomerular MAS receptor expression in patients of class IV wassignificantly weaker than class III. Tubule and vascular MAS receptor expression were similar to glo- menali. Conclusions Expression of AT1, AT2 and MAS receptors in renal biopsy tissue is associated with pathologic injury in DN patients, which provides more evidence to elucidate the role of RAS in DN.

关 键 词：活组织检查 血管紧张素类 糖尿病肾病 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]