尿液足细胞排泄与IgA肾病的相关关系

Relationship between Urinary Podocyte Excretion and IgA Nephropathy

目的探讨尿液足细胞排泄与IgA肾病病理损伤严重程度的相关性。方法36例IgA肾病患者,按IgA肾病病理组织学Lee分级分为4组,采用免疫酶细胞化学方法,应用小鼠抗人PCX单克隆抗体进行标记,计数足细胞,同时检测临床检验指标,进行尿液足细胞排泄水平及临床检验指标与IgA肾病病理损伤严重程度的分析。结果IgA肾病4组与1组相比,尿蛋白定量、血清胆固醇、血尿素氮及血清肌酐水平明显升高,血浆白蛋白水平明显降低;3组与1组相比,尿蛋白定量及血尿素氮水平明显升高;2组与1组相比,仅血尿素氮水平明显升高(P<0.05)。IgA肾病4组尿液足细胞排泄水平明显高于1组和2组(P<0.05);尿液足细胞排泄水平与IgA肾病Lee分级水平具有明显的相关性(r=0.432,P=0.01)。结论尿液足细胞的排泄水平随IgA肾病肾脏病理改变的加重而增多,两者具有明显的相关性。

Objective The aim of this study was to investigate the relationship between urinary podocyte excretion and severity of renal pathological injury in IgA nephropathy.Methods We selected 36 cases of patients with IgA nephropathy and divided into 4 groups according to Lee histopathological classification.Urinary podocytes were examined by immunocytochemistry methods and maked by mouse anti-human podocalyxin monoclonal antibody.We counted the podocytes and examined the laboratory index.We analyzed relationship between urinary podocytes,clinical laboratory index and renal pathological injury of IgA nephropathy.Results Urinary protein quantitation,cholesterol,urea nitrogen and serum creatinine in group 4 of IgA nephropathy were apparently more than that in group 1,and plasma albumin were apparently lower.Urinary protein quantitation and urea nitrogen were statistically difference between group 1 and group 3.However,only urea nitrogen in group 2 was statistically different from that in group 1（P〈0.05）.The number of podocytes in the urine of patients with in group 4 of IgA nephropathy were apparently more than that in group 1 and group 2（P〈0.05）.There was obvious correlation of urinary podocyte with Lee histopathological classification of IgA nephropathy（r=0.432,P=0.01）.Conclusion The mean level of podocytes in urinary excretion increased with pathological changes of IgA nephropathy aggravated,and there was obviousiy relative.