肾小球足细胞密度与IgA肾病病变进展的关系

Study on the relationship between the density of glomerular podocyte and the progression of IgA nephropathy

目的:探讨IgA肾病患者足细胞损伤的情况,并分析与病理指标的相关性。方法:收集53例IgA肾病患者的肾组织,用WT-1单克隆抗体对IgA肾病患者肾组织进行免疫组化染色,应用计算机图像分析软件测算肾小球足细胞密度,对IgA肾病患者不同病理状态下肾小球中足细胞数与病理指标的关系进行分析。结果:IgA肾病患者肾小球足细胞密度随着肾脏病理损伤程度的加重而降低,各组肾小球足细胞密度比较差异有统计学意义(P<0.01),与24 h尿蛋白定量、尿素氮(BUN)、血肌酐(Scr)均呈负相关(r24h尿蛋白定量=-0.427,P=0.001;rBUN=-0.426,P=0.002;rScr=-0.414,P=0.002);与肾小球滤过率估算值(e GFR)呈正相关(r=0.446,P=0.001);与新月体呈负相关(r=-0.336,P=0.014)。结论:IgA肾病患者随着肾脏病理损伤程度的加重,其肾小球足细胞密度逐渐下降,肾小球足细胞密度与尿蛋白、新月体等指标存在相关性,提示肾小球足细胞的缺失程度反映了IgA肾病的活动性和病变进展。

Objective： To investigate the injury of podocytes in patients with IgA nephropathy, and analyze the correlation with pathological indicators. Methods： Renal tissues of 53 patients with primary IgA nephropathy were collected in the day of kidney biopsy. WT - 1 monoclanal antibody was used to detect renal tissues in immunohistochemistry. The density of podocytes was calculated by computer image analysis software. The relationship between the amount of podocytes in different pathological situation and the pathological indicators were analyzed. Results： The density of podocytes in glomerulus was decreased with the increasing of the pathological grade. There was statistical significance of podocytes density in each group （ P 〈 0.01 ）. The density of podocytes was negatively correlated with 24 - hour urinary protein（ r = -0.427, P =0.001）, BUN（ r = -0.426, P =0.002）, Scr（ r = -0.414, P =0.002） and crescent （ r = -0.336, P =0.014） respectively, and positively correlated with eGFR （ r = 0. 446, P = 0.001 ）. Conclusion： With the exacerbation of renal injury in IgA nephropathy patients, the density of podocytes in glomerulus is decreased, which is correlated with proteinuria and crescent. The degree of podocyte loss in glomerulus reflects the activity and progression in IgA nephropathy.