IgA肾病患者IgM沉积表达与尿蛋白和肾脏病理变化的关系  

Relationship between IgM Deposition and Pathological Changes of Urinary Protein and Kidney in Adult IgAN Patients

作　　者：赵庆雨 ZHAO Qing-yu(Department of Nephrology,School of Medicine,Nanjing University,Nanjing,Jiangsu 210000)

机构地区：[1]南京大学医学院,江苏南京210000

出　　处：《医学临床研究》2018年第9期1709-1711,1714,共4页Journal of Clinical Research

摘　　要：【目的】探讨成年人IgA肾病（IgAN）患者免疫球蛋白M（IgM）沉积表达与患者尿蛋白水平、肾脏病理变化的关系。【方法】收集2012年1月至2017年1月本院收治的86例IgAN患者的I】名床资料，根据IgM沉积情况将其分为IgM阳性组（n=40）和IgM阴性组（n=46）。采用直接免疫荧光法检测患者IgM的沉积情况，分别对比两组间尿总蛋白（UTP）、尿蛋白排泄率（UAER）、尿B2微球蛋白（β2-MG）、尿a，微球蛋白（α1-MG）、Katafuchi半定量积分差异。【结果】IgM阳性组的UTP、UAER、尿β2-MG水平均高于IgM阴性组，差异均具有统计学意义（P〈0．05）；IgM阳性组与IgM阴性组的尿“rMG水平比较，差异无统计学意义（P〉0．05）。IgM阳性组的肾小球评分、肾小管间质积分及其总分均高于IgM阴性组，差异具有统计学意义（P〈0．05）；IgM阳性组与IgM阴性组的肾血管积分比较，差异具有无统计学意义（P〉0．05）。IgM阳性组Lee氏分级与IgM阴性组比较，差异无统计学意义（Z=-1．471，P=0．141〉0．05）。【结论】IgAN患者IgM沉积可促进患者肾功能进一步损伤，并加重肾脏的病理学损伤程度。[Objective]To investigate the relationship between the immunoglobulin M （IgM） deposition and the level of urinary protein and renal pathological changes in adult patients with IgA nephropathy （IgAN）. [Methods] A total of 86 patients with IgAN who were admitted to our hospital from January 2012 to January 2017 were selected for the detection of IgM deposition by direct immunofluorescence. Patients were divided into the IgM positive group （ n =40） and the IgM negative group（ n =46）. Total urinary protein, urinary protein excreation rate（UAER）, urine 132 microglobulin （]32-MG）, urinary al microglobulin （al-MG）, and Kata- fuchi were analyzed. [Results]The total urinary protein, UAER, and urine 132-MG in the IgM-positive group were higher than those in the IgM-negative group （ P （0.05）. There was no significant difference in urinary α1-MG levels between the two groups （ P〉0.05）. Glomerular score, tubulointerstitial score, and total score in the IgM positive group were higher than those in the IgM negative group （ P （0.05）. There was no significant difference in renal vascular scores between the IgM positive group and the IgM negative group （ P〉0.05） Also, there was no significant difference in the Lee＇s grade between the IgM positive group and the IgM negative group （ Z = -1.471, P =0.141〉0.05）.[Conclusion]IgM deposition in patients with IgAN can promote further damage to renal function and aggravate the pathological damage of the kidney.

关 键 词：肾小球肾炎 IOA/病理生理学 免疫球蛋白M 蛋白尿 

分 类 号：R692[医药卫生—泌尿科学]