原发性肾病综合征患儿肾组织P-gp170蛋白和mRNA表达与临床病理及预后的关系  

Relationship between the Expression of p-gp170 Protein and mRNA in Renal Tissue of Children with Primary Nephrotic Syndrome and Clinical Pathology and Prognosis

作　　者：刘广涛 关凤军 董晨 LIU Guang-tao1,GUAN Feng-jun2,DONG Chen2(1.Department of Pediatrics,the First People＇s Hospital,Changzhou 213000,Jiangsu,China;2.Department of Pediatrics,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,Jiangsu,China)

机构地区：[1]常州市第一人民医院儿科,江苏常州213000 [2]徐州医科大学附属医院儿科,江苏徐州221000

出　　处：《医学信息》2018年第21期61-65,共5页Journal of Medical Information

摘　　要：目的观察原发性肾病综合征患儿肾组织中P-糖蛋白170的表达,分析肾组织中P-gp170表达与临床和病理的关系,探讨P-gp170表达在PNS患儿GC耐药中的作用。方法采用肾活检术取得96例处于不同病程的PNS患儿肾组织标本,进行常规病理学诊断和肾脏病理定量分析;应用免疫组织化学及原位杂交法分别检测PNS患儿肾组织中P-gp170蛋白及m RNA的表达,比较不同肾脏病理类型及病理积分患儿P-gp170的表达;比较未用GC与应用GC后PNS患儿肾组织Pgp170的表达。结果 (1)正常肾脏即有一定量的P-gp170表达;未用GC组即高于正常对照,差异有统计学意义(P<0.05);(2)病理积分较高者P-gp170表达阳性量高于病理积分低者,差异有统计学意义(P<0.05);不同病理类型P-gp170的表达有差异,局灶节段硬化(FSGS)、膜性肾病(MN)和硬化性肾病(SGN)表达较高,组间比较差异无统计学意义(P>0.05),微小病变(MCD)和系膜增生型(MsPGN)者表达较低,两者比较差异无统计学意义(P>0.05);而前三者与后两者差异有统计学意义(P<0.05);(3)未用GC者较应用GC后的PNS患儿肾组织P-gp170表达量低,差异有统计学意义(P<0.05)。结论 P-gp170在PNS患儿肾组织的表达可能与肾病病损有关,可结合病理类型和病理损伤程度同时检测肾组织P-gp170预测不同患儿GC反应性; P-gp170的表达增高可能与PNS活动和复发有关,可作为临床预测预后的指标。Objective To observe the expression of P-glycoprotein 170 in renal tissues of children with primary nephrotic syndrome, and to analyze the relationship between P-gp170 expression and clinical and pathological changes in renal tissues, and to investigate the expression of P-gp170 in GC-resistant children with PNS effect. Methods Renal tissue samples from 96 children with PNS in different stages of disease were obtained by renal biopsy. The routine pathological diagnosis and quantitative analysis of renal pathology were performed.Immunohistochemistry and in situ hybridization were used to detect the expression of P-gp170 protein and mRNA in renal tissues of children with PNS, and the expression of P-gp170 in different renal pathological types and pathological scores were compared.The expression of P-gp170 in renal tissue of children with PNS after GC and GC application was compared.Results ①There was a certain amount of P-gp170 expression in normal kidney,The GC group was significantly higher than the normal control group,the difference was statistically significant （P〈0.05）.②The positive expression of P-gp170 was higher than the pathological score,the difference was statistically significant （P〈0.05）.The expression of P-gp170 was different in different pathological types. The expressions of focal segmental sclerosis （FSGS）, membranous nephropathy （MN） and sclerosing nephropathy （SGN） were higher. There was no significant difference between the two groups （P〉0.05）. The expressions of microscopic lesions （MCD） and mesangial proliferative （MsPGN） were lower,the difference was not statistically significant （P〉0.05）. The difference between the first three and the latter two was statistically significant （P〈0.05）.③The expression of P-gp170 in renal tissue of children with NS after GC was lower than that of patients with GC, the difference was statistically significant （P〈0.05）. Conclusion The expression of P-gp170 in renal tissue of PNS children may be re

关 键 词：肾病综合征 P-糖蛋白170 糖皮质激素 耐药 儿童 

分 类 号：R726.9[医药卫生—儿科]