糖尿病肾病患者肾小管上皮细胞DcR2、p16表达变化及其与肾组织损伤程度和肾功能的相关性分析

Analysis of expression of DcR2 and p16 and its correlation with renal injury and renal function in renal tubular epithelial cells in diabetic nephropathy

目的分析糖尿病肾病患者肾小管上皮细胞DcR2、p16表达变化及其与肾组织损伤程度和肾功能的相关性。方法选取60例糖尿病肾病患者为研究组,60例同期行肾脏肿瘤切除术取其病灶旁正常肾组织的患者为对照组,采用免疫组化法、免疫荧光法对DcR2、p16表达变化进行检测。分析肾小管上皮细胞DcR2、p16表达阳性率与临床相关资料的相关性,并评估肾小管上皮细胞DcR2、p16表达阳性率与肾组织损伤程度的相关性。结果研究组患者肾小管上皮细胞DcR2、p16表达阳性率均高于对照组患者(χ~2=9.35,15.94,均P<0.01),且研究组进展期糖尿病肾病患者肾小管上皮细胞DcR2、p16表达阳性率均高于早期糖尿病肾病患者(χ~2=11.96,14.97,均P<0.01)。研究组患者肾小管上皮细胞DcR2、p16表达变化与估计的肾小球滤过率呈负相关,与患者收缩压、尿蛋白定量、尿蛋白/肌酐、尿素氮(BUN)、甘油三酯(TG)、胱抑素c(Cyc)及血肌酐(Scr)呈正相关。研究组患者肾小管上皮细胞DcR2、p16表达变化与患者肾小管萎缩与间质纤维化、肾间质炎症、系膜增生及肾小球硬化病变程度存在显著性关系(P均<0.01)。结论糖尿病肾病患者肾小管上皮细胞DcR2、p16的表达变化与其肾组织损伤程度及肾功能均存在显著性关系,在肾组织损伤程度及肾功能中起到重要作用。

Objective To analyze the expression of DcR2 and pl6 and its correlation with renal injury and renal function in renal tubular epithelial cells in diabetic nephropathy. Methods 60 cases of diabetic nephropathy were selected in our hospital as the study group and 60 cases underwent renal tumor resection with normal renal tissue as the control group. The expression of DcR2 and pl6 were detected by the method of im- munohistochemistry and immunofluorescence. To investigate the correlation between the positive rate of DcR2 and pl6 expression in renal tubular epithelial cells and the clinical data, and to evaluate the correlation between the positive rate of DcR2 and pl6 expression in renal tubular epithelial cells and the degree of renal injury. Results The positive expression of DcR2 and p16 in renal tubular epithelial ceils in the study group were higher than those of the control group （ X^2 = 9.35, 15.94, both P 〈 0.01 ）, while the positive expression rate of DcR2 and P16 in renal tubular epithelial cells in patients with progressive diabetic nephropathy were higher than those of patients with early diabetic nephropathy （ X^2 = 11.96, 14.97, both P 〈 0.01 ）. The expression changes of DcR2 and pl6 in renal tubular epithelial cells in the study group showed negatively correlated with estimated glomerular filtration rate, and showed positively correlated with the systolic blood pressure, urine protein, urine protein/creatinine, blood urea nitrogen, triglyceride, Cystatin C and serum creatinine. The expression of DcR2 and pl6 in the renal tubular epithelial ceils of the stud- y group was significantly correlated with the degree of renal tubular atrophy and interstitial fibrosis, renal interstitial inflammation, mesangial prolif- eration and glomerulosclerosis. Conclusion The expression changes of DcR2 and pl6 in renal tubular epithelial cell in patients with diabetic ne- phropathy have a significant relationship between the renal tissue damage and renal function, so they play important roles in the degree of renal tis- sue damage and renal function.