抗中性粒细胞浆抗体与肾小球肾炎

Antineutrophil Cytoplasmic Antibody and Glomerulonephritis

目的 :研究抗中性粒细胞浆抗体 (antineutrophil cytoplasmic antibody,ANCA)与肾小球肾炎的关系。方法 :采用间接免疫荧光法及酶联免疫吸附法 ,对 48例各种类型的肾小球肾炎作血抗中性粒细胞浆抗体定性及定量测定 ,同时进行临床、病理、实验室检查对照。结果 :(1)在 48例肾小球肾炎患者中有 12例 ANCA阳性 ;(2 ) ANCA阳性患者的临床表现不尽相同 ;(3)在 ANCA阳性患者的肾小球内大多有新月体形成 ,血管病变及间质炎症 ;(4)ANCA阳性患者血中 TNF均高于正常值 ,在肾小球内的不同部位均可发现粘附因子 VCAM- 1沉积。结论 :一些肾小球肾炎实际上就是血管炎的一类 ,无论是病理变化 ,还是发病机理都有相同之处。

Objective:To study the relationship between antineutrophy cytoplasmic antibody and glomerulonephritis. Methods:Forty eight patients with glomerulonephritis verified by different histopathological features were investigated by indirect immunofluorescence and enzymelinked immunosorbent assays; besides,clinic,pathologic and lab examination were taken. Results:(1) 12/48 patients with glomerulonephritis were ANCA positive. (2) The clinical characteristics of ANCA positive patients differed. (3) There were crescent,vessel disease and interstitial inflammation in the glomeruli of ANCA positive petients. (4) Serum TNF of ANCA positive were higher than normal.The depositions of VCAM 1 in different parts of glomerulus were found. Conclusion:In fact,some glomerulonephritises were kinds of vasculitises.There are characteristics in common between them either in pathological varieties or in mechanism.