【摘要】 目的探讨IgA肾病肾组织中CD68、AngⅡ的表达及尿蛋白与肾间质损伤的关系。方法根据肾活检结果选取17例已经确诊的原发性IgA肾病的肾组织作为实验组。将肾间质损伤分为0～3级,记录其血肌酐、24h尿蛋白量。另取4例因肾外伤或肾肿瘤切除的患肾中的正常肾组织作为对照组。免疫组化法检测肾组织中CD68、AngⅡ的表达。结果 (1)肾间质损害1～3级的IgA肾病中,24h尿蛋白量与肾间质损害程度、血肌酐水平呈正相关(P<0.05)。(2)肾间质损害1～3级的IgA肾病组,肾间质中CD68的表达较正常对照组显著增高,差异有统计学意义(P<0.05)。肾间质内CD68的表达与24h尿蛋白量、肾间质损伤程度呈正相关(P<0.05)。(3)IgA肾病组AngⅡ的表达较正常对照组显著增高,差异有统计学意义(P<0.05)。AngⅡ的表达与24h尿蛋白量呈正相关(P=0.012)。结论 (1)蛋白尿参与了IgA肾病肾小管间质损害的病理过程,是导致IgA肾病恶化的主要因素之一,需早期应用ACEI/ARB等药物进行降蛋白尿治疗。(2)IgA肾病中单核/巨噬细胞的浸润参与了IgA肾病肾间质的损伤。更多还原

【Abstract】 Objective To investigate the expression of CD68,AngⅡin IgA nephropathy and the relationship of CD68,AngⅡ,urinary protein and interstitial injury.Methods According to biopsy results,renal biopsy specimens of 17 patients diagnosed primary IgA nephropathy were selected as experimental group.The renal interstitial injury were divided into 0-3 levels.And 24-hour urinary protein,serum creatinine were collected.The other four normal renal tissue taken from trauma patients or renal tumors were as control group.The expression of CD68 and AngⅡin renal tissue was investigated by immunohistochemistry.Results (1)24-hour urinary protein was positively correlated with serum creatinine and renal interstitial damage(P<0.05).(2)The expression of CD68 in IgA nephropathy(grade 1-3)was significantly higher than the control group(P<0.05).The expression of CD68 in renal interstitial was positively correlated with 24-hour urine protein and interstitial injury in IgA nephropathy which tubulointerstitial damage was grade 1-3(P<0.05).(3)The expression of AngⅡin IgA nephropathy was significantly higher than the control group(P<0.05).It was positively correlated with 24-hour urine protein(P=0.012).Conclusions (1)Proteinuria as an important factor was involved in tubulointerstitial damage of IgA nephropathy.It was one of the main factors leading to the deterioration of IgA nephropathy.These patients needed antiproteinuric treatment earlier by ACEI/ARB.(2)The expression of monocyte/macrophage′s infiltration participated in the interstitial injury.更多还原