摘要
目的:探讨免疫球蛋白A(IgA)肾病患者肾小球系膜组织P21、P27、增殖细胞核抗原(PCNA)表达与肾脏预后不良的关系。方法:选取2017年4月至2019年8月孝感市中心医院收治的145例IgA肾病患者作为研究对象,采用免疫组化法检测肾小球系膜组织P21、P27、PCNA的表达。所有患者均接受跟踪随访24个月,统计预后情况,对比不同预后患者肾小球系膜组织P21、P27、PCNA的表达,并采用Logistic回归分析法分析IgA肾病患者预后不良的影响因素。结果:IgA肾病患者肾小球系膜组织P21、P27、PCNA阳性细胞表达率分别为(38.69±6.83)%、(55.94±8.08)%、(33.47±5.72)%;IgA肾病患者预后不良发生率为17.24%,预后不良患者肾小球系膜组织P21、PCNA阳性细胞表达率均高于预后良好组(P<0.05),P27阳性细胞表达率低于预后良好组(P<0.05);经Logistic多元回归分析显示,舒张压升高、24 h蛋白尿增多、系膜细胞增生、节段性肾小球硬化、肾小管萎缩/间质纤维化、新月体与P21、PCNA阳性表达率升高、P27阳性细胞表达率降低均是影响IgA肾病患者预后不良的危险因素(P<0.05)。结论:IgA肾病肾小球系膜组织存在P21、P27、PCNA阳性表达,IgA肾病预后不良患者肾小球系膜组织P21、PCNA阳性细胞表达率均高于预后良好者,P27蛋白阳性细胞表达率低于预后良好者,且均为IgA肾病患者预后不良的危险因素。
Objective:To explore the relationship between the expressions of P21,P27 and proliferating cell nuclear antigen(PCNA)in glomerular mesangial tissue and poor renal prognosis in patients with immunoglobulin A(IgA)nephropathy.Methods:A total of 145 patients with IgA nephropathy treated in Xiaogan Central Hospital from April 2017 to August 2019 were selected as the research object.The expressions of P21,P27 and PCNA in glomerular mesangial tissue were detected by immunohistochemistry.All patients were followed up for 24 months,and the prognosis were counted.The expressions of P21,P27 and PCNA in glomerular mesangial tissue of patients with different prognosis were compared and the influencing factors of poor prognosis in patients with IgA nephropathy were analyzed by Logistic regression analysis.Results:The expression rates of P21,P27 and PCNA positive cells in glomerular mesangial tissue of patients with IgA nephropathy were(38.69±6.83)%,(55.94±8.08)%,(33.47±5.72)%,respectively.The incidence rete of poor prognosis in patients with IgA nephropathy was 17.24%,and the expression rates of P21 and PCNA positive cells in glomerular mesangial tissue of patients with poor prognosis were higher than those in good prognosis group(P<0.05),while the expression rate of P27 positive cells was lower than that in good prognosis group(P<0.05).Logistic multiple regression analysis showed that elevated diastolic blood pressure,increased 24 h proteinuria,mesangial cell proliferation,segmental glomerulosclerosis,renal tubular atrophy/interstitial fibrosis,crescentic body,increased expression rates of P21 and PCNA positive cells and decreased expression rate of P27 positive cells were all risk factors affecting the poor prognosis of patients with IgA nephropathy(P<0.05).Conclusion:There are positive expressions of P21,P27 and PCNA in glomerular mesangial tissue of IgA nephropathy.The expression rates of P21 and PCNA positive cells in glomerular mesangial tissue of of patients with poor prognosis of IgA nephropathy are higher than thos
作者
廖敏
宋勇波
魏卓
刘小兵
程魁
范哲奇
双松涛
祝存海
LIAO Min;SONG Yongbo;WEI Zhuo;LIU Xiaobing;CHENG Kui;FAN Zheqi;SHUANG Songtao;ZHU Cunhai(Department of Urology,Xiaogan Central Hospital,Xiaogan Hospital Affiliated to Wuhan University of Science and Technology,Xiaogan 432100,China)
出处
《中国免疫学杂志》
CAS
CSCD
北大核心
2024年第3期610-614,共5页
Chinese Journal of Immunology
