急性肾损伤患者肾成纤维细胞激活及相关性因素分析  

Renal Fibroblast Activation and Correlation Factors in Patients with Acute Kidney Injury

作　　者：叶寅寅[1] 郭蕊 杨晓明[1] 杨沿浪[1] YE Yin-yin;GUO Rui;YANG Xiao-ming;YANG Yan-lang(Department of Nephrology,Yijishan Hospital,Wannan Medical College,Wuhu,Anhui 241000,China;College of Clinical Medicine,Wannan Medical College,Wuhu,Anhui 241000,China)

机构地区：[1]皖南医学院弋矶山医院肾脏内科,安徽芜湖241000 [2]皖南医学院临床学院,安徽芜湖241000

出　　处：《河北北方学院学报（自然科学版）》2024年第12期17-20,24,共5页Journal of Hebei North University:Natural Science Edition

基　　金：安徽省教育厅课题(No.2023AH051759,No.2023AH030107);弋矶山医院人才引进项目(No.YR202213)。

摘　　要：目的探讨肾脏成纤维细胞在急性肾损伤时激活的特点以及相关性因素,为急性肾损伤的诊治提供参考。方法回顾性分析38例急性肾损伤患者的临床资料,按照肾功能及尿量水平将患者分成AKI 1~2期组和AKI 3期组。将患者肾组织切片进行PAS、S100A4免疫组化染色评估肾小管损伤程度以及成纤维细胞激活情况,分析2组患者性别、年龄、血压、住院日期及血肌酐、电解质、肝功能、血糖、尿酸、血红蛋白、成纤维细胞激活等方面的差异。结果急性肾损伤时肾小管上皮细胞脱落以及管型形成,尤其以AKI 3期明显;2组患者峰值肌酐、穿刺时肌酐有明显差异(P<0.001),组间尿酸亦存在差异(P=0.031),AKI 1~2期患者间质内S100A4阳性细胞数表达明显高于AKI 3期患者。Pearson相关性分析提示S100A4阳性细胞数与尿酸(r=-0.471,P=0.042)、峰值肌酐(r=-0.623,P=0.004)及穿刺时肌酐(r=-0.472,P=0.041)均呈负相关。结论急性肾损伤时伴随着成纤维细胞的激活,其激活有利于患者肾功能短期恢复。Objective To study the activation characteristics and correlation factors of fibroblasts in acute kidney injury,so as to provide basis for diagnosis and treatment of acute kidney injury.Methods Clinical data of patients with acute kidney injury were collected and retrospectively analyzed.Patients were divided into stage 1-2 and stage 3 according to renal function and urine volume.The renal tissue sections were stained with PAS and S100A4 immunohistochemical staining to assess the degree of renal tubular damage and fibroblast activation,and the differences in gender,age,blood pressure,hospital stay,serum creatinine,electrolyte,liver function,blood glucose,uric acid,hemoglobin,and fibroblast activation between the two groups were analyzed.Results Renal tubular epithelial cell shedding and tubulogenesis were particularly evident in patients with stage 3 of AKI patients.Peak creatinine and creatinine at puncture showed significant differences between the two groups(P<0.001),and uric acid was also different between the two groups(P=0.031).The expression of S100A4 positive cells in the interstitium of patients in stage 1-2 was significantly higher than that of patients in stage 3.Pearson correlation analysis showed that the number of S100A4 positive cells was negatively correlated with uric acid(r=-0.471,P=0.042),peak creatinine(r=-0.623,P=0.004)and creatinine at puncture(r=-0.472,P=0.041).Conclusion Acute kidney injury is accompanied by the activation of fibroblasts,which is conducive to the recovery of renal function.

关 键 词：急性肾损伤 成纤维细胞 激活 肌酐 尿酸 

分 类 号：R692[医药卫生—泌尿科学]