IgA肾病肾组织中单核／巨噬细胞浸润的意义

Role of monocyte/macdrophage in IgAnephropathy

本文用抗人巨噬细胞（ＣＤ６８）单克隆抗体免疫组化方法，研究了２０例原发性ＩｇＡ肾病患者肾组织中单核／巨噬细胞浸润与肾组织学损害程度、肾活检前临床参数间的关系。以６例尸体肾组织为对照。结果显示，ＩｇＡ肾病患者肾小球内ＣＤ６８阳性细胞主要位于系膜区、肾小球囊；间质中主要位于硬化的肾小球周围，散在或呈灶性分布于肾小管之间。ＭｅａｄｏｗⅢ级和Ⅳ级者肾小球内ＣＤ６８阳性细胞数和肾间质中ＣＤ６８阳性细胞百分数显著高于对照组，ＭｅａｄｏｗⅡ级者与对照组间差异不显著。肾间质中ＣＤ６８阳性细胞百分数与肾组织学损害程度、血清肌酐浓度（Ｓｃｒ）和２４ｈ尿蛋白量之间均呈正相关；肾小球中ＣＤ６８阳性细胞数与三者之间均无相关关系。本研究结果揭示，肾组织中尤其是肾间质中浸润的单核／巨噬细胞，可能在ＩｇＡ肾病进展过程中起着重要作用。

o evaluate the role of monocytelmacrophage in IgA nephropathy ,renal biop-sy specimens from 20 patients with the dis-ease were examined by indirect immunohis-tochemical staining (LSAB method) usingantihuman macrophage (CD68) monoclonalantibody (Clone Pg Mi). Six cadaveric kid-neys due to traffic accident were used ascontrols. The degree of renal lesion was divided into five grades according to the criteria of meadow classification. The number ofCD68+ cells in glomeruli and interstitium ofthe patients with grade Ⅲ and Ⅳ was sig-nificantly higher than that of controls.There was a positive correlation betweenCD68+ cell percentage in interstitium andMeadow grading (r= 0. 7083 ,P>0. 001 ) . Inglomeruli, CD68+ cells were located inmesangial areas and Bowman's space. CD68+cells were observed mainly around scleroticglomeruli in interstitium. Clinicopathy-logical study showed a positive correlationbetween CD68+ cell percentage in intersti-tium and serum creatinine (r=0. 5000. P<0. 05) and 24 hour urinary protein (r= 0.6008, P < 0. 01 ). These results suggestedthat monocytes/macrophages might play animportant role in the progression of IgAneph ropathy .