IgA肾病肾小管间质中淋巴细胞亚群分布及其临床意义探讨

The distribution and clinical significance of lymphocytes and their subsets in renal tubulointerstitium in IgA nephropathy

目的:探讨IgA肾病(IgA nephropathy,IgAN)肾小管间质中淋巴细胞亚群分布与临床肾功能的关系及其意义。方法:对48例IgAN患者穿刺肾组织石蜡切片行Masson三色染色,按牛津分类将48例IgAN患者分为T0、T1和T2组,用CD4、CD8和CD20一抗行免疫组化染色,分别标记T淋巴细胞亚型(CD4、CD8)和B淋巴细胞(CD20)。采用Image-Pro Plus图像分析系统分析免疫组化结果,结合相关病理参数(肾小球硬化、肾小管萎缩、间质纤维化程度)及临床指标,应用SPSS 13.0统计软件进行统计学分析。结果:CD4^+、CD8^+、CD20^+的细胞数量在不同纤维化组别间差异有统计学意义(P<0.05)。CD4^+、CD8^+、CD20^+的细胞数量与不同临床、病理指标呈正相关。结论:间质中浸润淋巴细胞的不同数量和类型影响IgAN临床特征及肾脏纤维化的进展。

Objective： To investigate the distribution and clinical significance of lymphocytes and their subsets in renal tubulointerstitium of IgA nephropathy（ IgA nephropathy,IgAN）. Methods： We stained paraffin sections of 48 cases of IgAN patients for Masson. According to Oxford classification,48 cases of IgAN patients were divided into 3groups： T0,T1 and T2. CD4,CD8 and CD20 primary antibodies were immunohistochemically stained,and marked as T lymphocyte subsets（ CD4^＋,CD8^＋）,B lymphocytes（ CD20^＋）,respectively. Immunohistochemistry results were analyzed by Image-Pro Plus image system,combined with the related pathological parameters（ glomerulosclerosis,tubular atrophy,interstitial fibrosis） and clinical index. We also used SPSS 13 statistical software for statistical analysis. Results：There was a significant difference between the quantity of CD4^＋,CD8^＋,CD20^＋cells between different fibrosis groups,P〈0. 05. The number of cells of CD4^＋,CD8^＋and CD20^＋was positively correlated with different clinical and pathological indexes. Conclusion： The number and type of infiltrating lymphocytes in renal tubular interstitium influence IgAN clinical features and the progress of renal fibrosis.