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粘附分子选择素在IgA肾病中变化的临床意义 |
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周 同 李 晓 郝翠兰 傅秀兰 姚 建 陈 楠 董德长
中国图书分类号 R593.24
摘 要 目的：为探讨IgA肾病患者血和肾组织中P选择素改变与疾病的关系。方法：采用酶联免疫吸附法、免疫组化及原位杂交技术检测了45例IgA肾病患者血浆和肾组织中P选择素含量及表达水平。结果：IgA肾病患者血浆P选择素含量明显高于正常人，其中肾病综合征组和肾功能减退组含量又较肉眼血尿组、尿检异常组和肾炎综合征组显著增高。P选择素在患者肾组织中广泛表达，其中在Ⅳ级和Ⅴ级IgA肾病肾小球中表达水平明显高于Ⅱ级和Ⅲ级，而它们在肾小管、肾间质中的表达水平又与肾小管间质病变程度密切相关。结论：P选择素可能参与了IgA肾病的发病机制，其血和肾组织中水平可成为判断IgA肾病严重程度及预后的指标。
关键词 IgA肾病 粘附分子 P选择素
Significance of P-selectin expression in IgA nephropathy
ZHOU Tong, LI Xiao, HAO Cui-Lan et al.
Department of Nephrology, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025
Abstract Objective: To investigate the role of P-selectin in IgA nephropathy (IgA N). Methods: Serum P-selectin level was measured by ELISA and P-selectin expression in renal tissue was detected by immunohistochemistry and in situ hybridization in 45 patients with IgA N. Results: s-P-selectin level in the patients was significantly higher than the controls. That in the patients with nephropathy syndrome or renal function insufficient was much higher than in the patients with gross hematuria, abnormal urine analyses or nephritis syndrome. P-selectin extensively expressed in renal tissue in IgA N. Up-regulated glomerular expression of P-selectin in class Ⅳ and Ⅴof IgA N was higher than in classⅡ and Ⅲ. Moreover P-selectin expression in renal tubule and interstitium was associated with tubulointerstitial lesions. Conclusion: The results suggested that P-selectin might play an important role in IgA N, and the level of P-selectin in serum and renal tissue might predict renal outcome in IgA N.
Key words IgA nephropathy Adhesion molecules P-selectin
IgA肾病是最常见的肾小球疾病之一，近年对其研究已取得长足进展［1］。目前细胞粘附分子在肾小球疾病中的作用已引起人们关注［2］，然而有关选择素与IgA肾病关系的研究报道尚不多见。故本研究检测了45例IgA肾病患者血浆和肾组织中P选择素含量及表达，并就其临床意义进行探讨。
1 材料与方法
1.1 对象 由本科肾活检（光镜、免疫荧光、电镜）和临床资料确诊的45例IgA肾病患者，男性25例，女性20例，年龄12～61岁(平均年龄25.4岁)。所有患者均排除系统性红斑狼疮、肝脏疾病、过敏性紫癜及肿瘤等所致的继发性IgA肾病[1] [2] 下一页
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