肾脏疾病时载脂蛋白在肾小球沉积的临床意义

The relationship between the deposition of apolipoproteins in glomeruli and the clinical findings in renal diseases

目的了解载脂蛋白（Ａｐｏ）Ｂ及Ｅ在肾脏的沉积和肾脏疾病的关系。方法对４３例肾脏疾病患者的肾脏活检标本进行免疫组化分析，同时进行系列的临床观察。结果ＡｐｏＢ和ＡｐｏＥ在肾脏疾病时多数呈颗粒状沉积在肾小球系膜和毛细血管襻内，ＡｐｏＢ和ＡｐｏＥ沉积均阳性者有明显的弥漫系膜细胞及基质增生，同时有明显的肾小球粘连和硬化。此外尚发现ＡｐｏＢ阳性组和ＡｐｏＢ及ＡｐｏＥ均阳性组蛋白尿，肾功能损害更严重（Ｐ＜００５）。结论ＡｐｏＢ和ＡｐｏＥ在肾脏的沉积可引起明显的肾小球系膜损害，加速肾小球硬化，并引起比较严重的蛋白尿和肾功能减退。

Objective In order to study the relationship between the deposition of ApoB, ApoE and renal diseases. Methods Analysis of the specimen of renal biopsy from 43 patients with renal diseases was carried out with immunohistological localization. Clinical observation was also done. Results ApoB and ApoE were demonstrated to deposit with a granular pattern in the glomeruli and the capillary loop, mainly in the mesangial lesions. Both ApoB and ApoE positive cases exhibited an aparent diffuse mesangial cell and matrix proliferation, glomerular adhesion and sclerosis, associate with severe proteinuria and poor renal function (all P<0.05). Conclusion It is suggested that deposition of ApoB and ApoE in the kidney can cause progression of mesangial lesions and acceleration of glomerular sclerosis with resulting heavy proteinuria and decrease of renal function.