【摘要】 目的探讨上皮细胞转分化与IgA肾病临床病理的相关性。方法选取2011年1月至2013年12月在新桥医院肾内科肾活检确诊为IgA肾病患者168例,根据免疫组织化学染色分为转录因子(Snail)、平滑肌肌动蛋白-a(a-SMA)高表达组(A组,117例)和Snail、a-SMA低表达组(B组,51例),并对两组患者年龄、性别、病程、体质量指数(BMI)、生化指标(肌酐、尿素氮、三酰甘油、24h尿蛋白定量、总胆固醇、血清清蛋白、血清总蛋白、血糖)及病理情况进行统计学比较。结果 A组患者病程、BMI与B组差异均有统计学意义(P<0.05)。A组肌酐、尿素氮、三酰甘油、24h尿蛋白定量与B组差异均有统计学意义(P<0.05)。B组病理分级多为Ⅰ、Ⅱ、Ⅲ级,而A组病理分级多在Ⅳ、Ⅴ级,病理分级Ⅳ和Ⅴ级IgA肾病患者Snail、a-SMA高表达的比例明显高于Ⅰ、Ⅱ级(40.2%vs.9.4%),两组间比较差异有统计学意义(P<0.05)。结论 IgA肾病患者Snail、a-SMA表达水平与24h尿蛋白定量、肾功能损害相关,Snail、a-SMA高表达者Lee氏分级较差。更多还原

【Abstract】 Objective To analyze the correlation between the epithelial-mesenchymal transition and the clinicopathologic features of IgA nephropathy.Methods A total of 168 patients diagnosed as IgA nephropathy by renal biopsy in Xinqiao hospital from January 2011 to December 2013 were divided into high expression of dual-positive Snail and a-SMA group(Group A,117cases)and low expression of dual-positive Snail and a-SMA group(Group B,51cases)according to results of immunohistochemical method.The clinical parameters(age,gender,course of disease,BMI and chemical indicators)and renal pathology grade were compared by statistical analysis.Results There were difference between group A and group B in the course of disease and BMI(P<0.05).There were differences between group A and group B in the incidences of creatinine,blood urea nitrogen,serum triglycerides and 24-hour urine protein amount(P<0.05).The percentage of Lee′s grade Ⅰ,Ⅱ,Ⅲin group B was significant,while percentage of Lee′s gradeⅣ+Ⅴin group A was significant.The expression of Snail and a-SMA in gradeⅣ+Ⅴ was more than that in gradeⅠ+Ⅱ(40.2%vs.9.4%),and the difference between two groups was statistically significant(P<0.05).Conclusion The expression of Snail and-SMA were related with 24-hour urine protein amount and kidney function in IgA nephropathy;and Lee′s grade was severe in patients with high expression of Snail and-SMA.更多还原