先兆子痫肾病患者肾组织中血管内皮细胞生长因子表达的临床意义

The Clinical Significance of the Expression of Vascular Endothelial Growth Factor in the Kidneys of Patients with Preeclamptic Nephropathy

目的:了解血管内皮细胞生长因子(VEGF)在先兆子痫肾病患者肾组织中表达的意义及其与先兆子痫肾病临床和病理表现之间的关系。方法:以正常肾组织为对照,采用特异性抗体和免疫组织化学染色方法对19例先兆子痫肾病患者肾组织中VEGF分布及其强度变化进行观察,分析其与内皮细胞增生、蛋白尿之间的关系。结果:先兆子痫肾病患者肾组织中VEGF表达在妊娠终止后早期阶段无论在强度变化上,还是在分布上与正常人相比均有明显差异,随着妊娠终止后时间的延长,VEGF的表达逐渐减弱并恢复至正常表达水平(P<0.01)。先兆子痫肾病患者肾组织VEGF的表达还与肾小球内皮细胞增生程度关系密切,VEGF表达增强组患者肾小球内皮细胞增生程度明显高于VEGF正常表达组(P<0.05)。此外,还发现VEGF表达增强组患者蛋白尿程度明显高于VEGF正常表达组(P<0.05)。结论:先兆子痫肾病肾组织中VEGF的表达与内皮细胞损伤所致的形态学改变、蛋白尿之间关系密切,且肾组织VEGF的表达随着妊娠终止后时间的延长逐渐减弱并恢复至正常表达水平。

Objective： To investigate the distribution and expression of vascular endothelial growth factor（VEGF） in the kidneys of patients with preeclamptic nephropathy and their relationship with clinical and pathological manifestations. Methods： 19 patients with preeclamptic nephropathy were enrolled in this study, whose renal tissue were subjected to immunohistochemical staining by 4 - layed PAP method using monoclonal anti - VEGF. Normal renal tissue from nephrectomy was served as control. The relationship of expression pattern of VEGF and clinic pathological manifestation was also investigated, Results： It was found that there were marked differences on the distribution and staining intensity of VEGF protein in the kidney of the patients with preeclamptic nephropathy on the early stage of gestation termination in comparison with those in the kidney of normal group, But the expression of VEGF protein gradually weakened and recovered to normal level with the prolonging time of gestation termination（ 100 % vs 71.43 % vs 20 %, P 〈 0.05）, In addition, it was detected that the expression of VEGF in the kidney of patients with preeclamptic nephropathy was closely relative with the proliferative extent of endothelial cells in the glomeruli, The level of VEGF in the groups of diffuse proliferation was stronger than that in the groups of segmental proliferation （ P 〈 0.05 ）. Furthermore, there was proportional relationship between the expression of VEGF and the level of proteinuria（ P 〈 0.05）. Conclusion： The expression of VEGF in glomeruli closely associated with glomerular endothelial lesion and proteinuria in patients with preeelampsia nephropathy. In addition, the expression of VEGF protein gradually weakened and recovered to normal level with the prolonging time of gestation termination.