Ⅳ型胶原的表达及血管病变在IgA肾病中的意义

Significance Of The Expression Of CollagenⅣIn Glomeruli And The Lesions Of Vascular In Iga Nephrop- athy

目的探讨Ⅳ型胶原的表达及血管病变在IgA肾病中的意义。方法采用特异性抗体及免疫组织化学染色方法,对经肾活检诊断的30例不同病理改变的IgA肾病患者肾组织中的Ⅳ型胶原的表达及血管病变与临床指标(病程、血压、肾功能改变)进行分析。结果在IgA肾病患者肾组织中,肾小球内Ⅳ型胶原随病变加重表达增多,在重度病变组表达最多(P<0.01);随病理改变程度加重,血管病变也加重。多因素分析显示高血压、年龄、病理分级Ⅲ级以上(Lee分级)对血管病变的发生影响有显著意义。结论在IgA肾病中Ⅳ型胶原的表达及血管病变与血压、尿蛋白定量、血肌酐水平等临床指标能够反映病变的程度,可以作为判断预后及干预治疗的一个重要病理指标。

Objective To examine Significance of the expression of collagenⅣin renal tissure and the lesions of vascular in IgA nephropathy.Method 30 patients with different renal biopsy-proven IgAN enrolled this study,whose renal tissue were subjected to immunohistochemical staining using monoclonal antibodies.The relationship of the expression pattern of collagenⅣand the lesions of vascular,clinicopathological manifestation was also investigated. Result As the pathological change of IgA nephropathy aggravated,the levels of urine protein,blood pressure and serum creatinine increased（P〈0.05）.The expression of collagenⅣincreased with the aggravation of the pathological change,and was the highest in the group of serious lesion（P〈0.01） As the patholo gical change of IgA nephropathy aggravated,the lesions of vascular aggravated（P〈0.05）.Multivariate logistic regression analysis showed that the significant influencing factors on vascular lesions included hypertension,age,and pathological gradeⅢ～Ⅴ.Conclusion In patients with IgAN,the expression of collagenⅣin glomeruli and the lesions of vascular parallels the blood pressure,serum triglyceride,urine protein,serum creatinine,etc.it reflects the disease degree and Can be used as important histological prognostical indicators.