摘要
目的研究尿足细胞与狼疮肾炎(LN)的关系,探讨尿足细胞评估LN肾损伤的临床价值。方法选取20例行肾活检的IN患者,收集相关临床资料,光镜观察肾组织病理改变;电镜观察足细胞超微结构变化;免疫组化检测肾足细胞蛋白Nephrin的表达;免疫荧光技术检测Podoealyxin表达来计数尿足细胞数量。结果20例LN病理显示Ⅲ型2例、Ⅳ型12例、Ⅳ型+V型4例、V型2例,足细胞标志蛋白Nephrin表达较正常组明显减低,且Ⅳ型、V型降低更明显。尿足细胞阳性检出率约80%,尿足细胞数量与肾足细胞相关蛋白Nephrin的表达呈负相关(r=-0.627,P〈0.01),与狼疮活动性呈正相关(r=0.571,P〈0.05),与24h蛋白定量无明显相关性(r=0.215,P〉0.05)。结论尿足细胞数量可监测狼疮活动及肾小球损伤程度,为LN病理分型提供参考。
Objectives To study the relationship of urinary podocytes with lupus nephritis ( LN), and to investigate the clinical value of urinary podoeyte as a marker of kidney injury in lupus nephritis. Methods Clini- cal dates were collected in the kidney biopsy of 20 patients with lupus nephritis. Renal histomorphology was observed by optic microscope and transmission electron microscope. The expression of nephrin protein was examined by immunohistoehemistry. Urinary podoeytes were identified and quantitated by immunofluorescence staining of urinary sediments labeled by monoclonal antibody podocalyxin. Results Renal pathological findings of the patients could be classified into class Ⅲ (n =2) , class Ⅳ (n =12) , class IV + V (n =4) , class V (n =2). Nephrin protein levels were substantially lower than in the normal group, and in class IV, VLN dreased obvious. 80% of the patients had urinary podoeytes. The number of urinary podoeytes was negatively correlated with nephrin expression in glomerular ( r = - 0. 627, P 〈 0.01 ), glomerular pathological activity index ( r = 0. 571, P 〈 0. 05 ) and no significant correlation with 24h protein excretion ( r = 0.215, P 〉 0.05 ). Conclusions The use of technology for detecting urinary podocytes may be markers of the severity of lupus nephritis and the activity, and protive reference for LN pathological class.
出处
《国际泌尿系统杂志》
2015年第4期571-574,共4页
International Journal of Urology and Nephrology