摘要
目的探讨尿脱落足细胞与IgA肾病患者临床、病理变化及其严重程度的相关性,以期指导治疗及评估预后。方法收集IgA肾病患者尿液,通过间接免疫荧光法检测尿中足细胞Podocalyxin蛋白表达判断尿脱落足细胞数量,并通过多因素逐步线性回归分析尿脱落足细胞与IgA肾病活动性或疾病进展的相关性。结果①尿脱落足细胞数量:IgA肾病患者显著高于对照组(P<0.01);不同程度蛋白尿组中尿中脱落足细胞数量有统计学差异(P<0.05);②相关性分析结果显示:尿脱落足细胞与IgA肾病活动性指标如破坏肾小球毛细血管袢活动性指数(dGAI)、肾小球慢性病变指数(GCI)、肾间质炎症细胞浸润指数(infI)、肾小管萎缩和肾间质纤维化指数(TCI)、小动脉慢性病变指数(VCI)、总评分、肾间质损害程度及肾间质评分之间均呈显著的正相关(R分别为0.225、0.325、0.243、0.335、0.226、0.409、0.511和0.262,P分别为0.003、0.001、0.017、0.001、0.027,<0.001、<0.001、<0.001);③逐步线性回归分析显示,24h尿蛋白定量、收缩压、舒张压、以及dGAI指数、TCI指数进入尿脱落足细胞回归方程。结论尿足细胞脱落在一定程度上可以提示IgA肾病的活动性病变,并与肾小管间质损害相关,有可能作为反映疾病进展的重要指标。
Objective To investigate the correlation between the number of urinary podocytes and clinicopathology in lgA nephropathy （IgAN） patients so as to provide guidance for treatment and evaluate prognosis. Methods Morning urinary specimens on the day of renal biopsy were collected from IgAN patients. Immunohistochemical staining with monoclonal anti-podocalyxin antibody was performed to detect urinary podocytes and the number of podocytes was counted under optical microscope. Correlation of the number of urinary podocytes with pathological score and clinical data was analyzed by multi-factor stepwise regression. Results （9 Excretion of urinary podocytes in IgAN patients was obviously higher than that in healthy controls （P 〈 0. 01）. Besides, significant differences were found in the number of urinary podocytes among patients with different degree of proteinuria （PG0.05）. @ Correlation analysis showed that urinary podocyte excretion was positively correlated with dGAI, GCI, infI, TCI, VCI, the total score, interstitial damage degree and interstitial score （R value = 0.225, 0.325, 0.243, 0.335, 0.226, 0.409, 0.511 and 0.262, respectively; P value=0.003, 0.001, 0.017, 0. 001, 0. 027, G0. 001, G0. 001 and 〈0. 001, respectively）. （3） The stepwise regression analysis showed that 24 h proteinuria, blood pressure, dGAI and TCI entered the regression equation of urinary podocyte excretion. Qonclusion The number of urinary pedocytes suggests active lesion of IgAN and may be related to interstitial damage. It may be used as a marker of the progression of IgAN.
出处
《西安交通大学学报（医学版）》
CAS
CSCD
北大核心
2014年第2期258-262,共5页
Journal of Xi’an Jiaotong University（Medical Sciences）
基金
国家自然科学基金资助项目(No.81200528)~~
关键词
尿
脱落足细胞
IGA肾病
肾病活动性指标
urine
urinary podocyte
IgA nephropathy
marker of the progression of IgAN
