慢性肾脏病血清及尿液Ⅳ型胶原和层黏连蛋白与肾组织纤维化的关系

Relation of Serum and Urinary Type Ⅳ Collagen and Laminin to Renal Fibrosis with Chronic Kidney Disease

目的 探讨慢性肾脏病（Chronic Kidney Disease,CKD）血清及尿液Ⅳ型胶原和层黏连蛋白与肾组织纤维化的关系.方法 以63例住院接受肾穿刺活检、未接受糖皮质激素、免疫抑制剂、血管紧张素转化酶抑制剂、血管紧张素Ⅱ受体拮抗剂和中草药等治疗的1～2期的CKD患者为研究对象,其中男性38例,女性25例.年龄为（40.5±17.5）岁,最小23岁,最大58岁.血清及尿液Ⅳ型胶原、层黏连蛋白采用酶联免疫吸附法测定.肾组织ColⅣ、LN表达强度利用病理图像分析软件对免疫组化阳性目标进行光密度测定.分析肾组织Ⅳ型胶原、层黏连蛋白光密度与血清、尿液Ⅳ型胶原、层黏连蛋白水平的关系.应用SPSS 11.0软件包进行统计分析,单因数相关分析采用Pearson相关分析.结果 CKD患者血清中Ⅳ型胶原及层黏连蛋白水平与肾组织纤维化程度无关,而尿液Ⅳ型胶原及层黏连蛋白水平与肾组织纤维化程度呈正相关.结论 尿液Ⅳ型胶原、层黏连蛋白水平能够反映早期CKD患者肾脏纤维化发生的程度.

Objective The objective is to study the relation of type Ⅳ collagen（ Col Ⅳ） and laminin（ LN） level of serum and urine to renal fibrosis with early CKD patients. Methodology 63 cases in stages1 to 2 CKD, hospitalized for renal biopsy,but did not receive corticosteroids,immunosuppressive agents,angiotensin converting enzyme inhibitors,angiotensin II receptor blockers and herbs treatment patients as the research object. The determination of serum and Col Ⅳ and LN by ELISA. Optical density of Col Ⅳ and LN of the pathological image on the positive goal of the immunohistochemistry of renal tissue were measured by analysis software. Results There was significantly positive correlation between the level of urinary Col Ⅳ and optical density of Col Ⅳ in kidney（ r = 0. 66,P〈0. 05）,and between the level of urinary LN and optical density of LN in kidney（ r = 0. 73,P〈0. 05）. There was not positive correlation between the level of serm Col Ⅳ and integrated density of Col Ⅳ in kedney（ P〈0. 05）,and between the level of serm LN and optical density of LN in kidney（ P〈0. 05）. Conclusion Renal fibrosis can be judged by determination of urinary Col Ⅳ and LN in early CKD patients.