原发性肾小球疾病患者血红素氧合酶-1的表达及其与患者临床特征的关系研究

Expression of HO-1 in Patients of Primary Glomerulopathy and Its Relationship with Clinical Features

目的观察原发性肾小球疾病患者血红素氧合酶-1(HO-1)的表达,分析其与患者临床特征的关系。方法选择2012年11月—2013年3月我院收治的原发性肾小球疾病患者33例为病例组,根据肾小管间质损害程度分为4个亚组:A组8例、B组11例、C组9例、D组5例;选取同期在我院健康体检正常者10例为对照组。采用间接免疫荧光法(IIF)检测受检者肾组织HO-1表达强度,酶联免疫吸附试验(ELISA)检测尿HO-1表达水平。相关分析采用Pearson或Spearman相关分析。结果 B组和C组患者肾组织HO-1表达阳性,且均在肾小管表达,B组表达强度高于C组(P<0.05);4个亚组患者肾组织HO-1表达强度、半定量积分总分、平均动脉压、尿素氮、血肌酐、尿比重、估测的肾小球滤过率(eGFR)比较,差异均有统计学意义(P<0.05)。对照组尿HO-1表达水平〔(145.90±55.27)ng/L〕低于病例组〔(207.83±62.51)ng/L〕,差异有统计学意义(t=2.813,P=0.007)。相关性分析结果显示,肾组织HO-1表达强度与半定量积分总分呈负相关(r=-0.436,P=0.013),与eGFR呈正相关(r=0.362,P=0.046);尿HO-1表达水平与半定量积分总分呈正相关(r=0.335,P=0.041)。结论原发性肾小球疾病患者肾小管HO-1表达增强,且与肾小管间质损害程度呈负相关;尿HO-1表达水平与肾小管间质损害程度呈正相关,HO-1的检测可能作为评估肾间质纤维化程度的指标。

Objective To investigate the expression of heme oxygenase-1（HO-1） in patients with primary glomerulopathy and to analyze its relationship with clinical features.Methods 33 cases with primary glomerulopathy admitted to our hospital from November 2012 to March 2013 were involved as the case group,and were further divided into four groups according to the level of tubulointerstitial lesions： group A（8 cases）,group B（11 cases）,group C（9 cases） and group D（5 cases）.10 healthy people were involved as the control group.Indirect immunofluorescence（IIF） was used to detect the expression of HO-1 in renal tissues,and ELISA was used to detect the expression of HO-1 in urine.Pearson or Spearman correlation analysis was adopted.Results The expression of HO-1 was positive in renal tissues of group B and group C,and both groups showed expression in kidney tubules,with the expression level higher in group B than in group C（P《0.05）.The HO-1 expression level,semi-quantitative total score,average arterial pressure,urea nitrogen,serum creatinine,urine specific gravity and estimated glomerular filtration rate in the four sub-groups showed statistically significant differences（P《0.05）.The expression level of HO-1 in urine in the control group 〔（145.90 ± 55.27） ng / L〕 was significantly lower than that in the case group 〔（207.83 ± 62.51） ng / L〕（t = 2.813,P = 0.007）.Correlation analysis showed that the HO-1 expression in renal tissues was negatively correlated with semi-quantitative total score（r =-0.436,P = 0.013）,was positively correlated with estimated glomerular filtration rate（r = 0.362,P = 0.046）.The expression level of HO-1 in urine was positively correlated with semi-quantitative total score（r = 0.335,P = 0.041）.Conclusion The expression level of HO-1 is increased in primary glomerulopathy patients,and is negatively correlated with the level of tubulointerstitial lesions.The expression level of HO-1 in urine is positively correlated with the level of tubulointerstitial lesions.The detection of HO-1 can be regarded as an index for the evaluation of renal interstitial fibrosis.