尿液MCP-1在评价IgA肾病病变活动性中的临床应用价值

Urinary monocyte chemoattractant protein-1 （MCP-1） in assessment of disease activity of IgA nephropathy

目的探讨IgA肾病（IgAN）患者尿液单核细胞趋化蛋白-1（MCP-1）的表达水平及其与临床和肾脏病理的关系。方法随机分为IgAN组（69例）和健康对照组（16例），采用酶联免疫吸附法测定两组尿液MCP-1浓度，并分析其与肾脏病理的总活动性指数（A1）和慢性指数（CI）的相关性；同时根据有无毛细血管襻坏死、有无细胞性新月体形成及系膜细胞增生程度、肾间质炎性细胞浸润程度将患者分组，并观察各组尿液MCP-1及其与24h尿蛋白定量、Scr、肾小球滤过率（GFR）等临床指标的相关性。结果IgAN组患者尿液MCP-1浓度较健康对照组增高（P〈0.05）；尿液MCP-1浓度与AI呈正相关（P〈0.05），而与Cl无相关性（P〉0.05）；细胞性新月体组和襻坏死组尿液MCP-1浓度均较无新月体、无襻坏死组增高（均P〈0.05）；尿液MCP-1浓度与24h尿蛋白定量呈正相关（P〈0.05），而与Scr和GFR无相关性（均P〉0.05）。结论尿液MCP-1可较好反映IgAN患者肾脏活动性病变。

Objective To investigate urinary concentration of monocyte chemoattractant protein-1 （MCP-1） in patients with IgA nephropathy （IgAN） and its relationship with disease activity. Methods Sixty nice IgAN patients confirmed by renal biopsy and 16 healthy controls were enrolled in the study. Urinary concentration of MCP-1 was detected by enzyme-linked immunosorbent assay （ELISA）, 24-h proteinuria, serum creatinine and glomerular filtration rate （GFR） were also measured. Correlation analysis of urinary MCP-1 with activity indices （AI） and chronic indices （CI） of renal histopathologic change was performed. Results Urinary MCP-1 concentration was significantly higher in IgAN patients than that in normal controls （P〈0.05）, which was positively correlated with AI of renal histopathologic change （P 〈0.05）. Urinary MCP-1 level markedly increased in IgAN patients with segmental necrosis or cellular crescent （P〈0.05）. Urinary MCP-1 was significantly correlated with 24-hr proteinuria （P 〈0.05}, but not correlated with serum creatinine and GFR. Conclusion Urinary MCP-1 level is helpful to assess disease activity of IgAN.