肾小管间质性肾炎抗原在慢性肾脏病中的表达及其临床意义

Expression of renal tubulointerstitial nephritis antigen in chronic kidney disease and its clinical significance

目的探讨肾小管间质性肾炎抗原(TIN-ag)在慢性肾脏病(CKD)中的表达及其临床意义。方法 76例CKD患者作为研究对象,将其按照病理检查结果分为微小病变组(对照组)和非微小病变组(观察组),每组38例。采用苏木精-伊红染色(HE染色)和Masson染色观察肾脏普通病理改变;采用免疫荧光检测肾脏组织TIN-ag的表达变化。结果通过对患者常规病理检查发现,对照组患者在HE染色显示下,肾间质和肾组织小管无明显异常,光镜观测下足突融合正常;观察组患者肾小球发生病变,并伴随有局部间质纤维化肾小管萎缩的情况。在免疫荧光显示下,对照组患者肾组织系统的TIN-ag症状表达清晰,观察组表达相对较弱;两组患者的免疫荧光吸光度(A)为:观察组4.72(3.01,10.63),对照组21.79(8.17,35.07),比较差异具有统计学意义(P<0.05)。原发性局灶性节段性肾小球硬化(FSGS)、IgA肾病、膜性肾病(MN)、狼疮性肾炎(LN)的免疫荧光吸光度比较差异无统计学意义(P>0.05)。结论非微小病变CKD患者的肾组织TIN-ag表达显著低于微小病变CKD患者,故TIN-ag在肾脏的生理病理意义上有着很大的探索价值。

Objective To discuss the expression of renal tubulointerstitial nephritis antigen（TIN-ag） in chronic kidney disease（CKD） and its clinical significance.Methods A total of 76 CKD patients as study subjects were divided by pathological examination results into minimal lesion group（control group） and non-minimal lesion group（observation group）,with 38 cases in each group.The renal pathological changes were observed by hematoxylin-eosin staining（HE staining） and Masson staining,and the changes of expression of TIN-ag in renal tissue was detected by immunofluorescence.Results Through routine pathological examination,the control group had no obvious abnormality in tubules of renal interstitium and renal tissue under HE staining,and the syndesmosis was normal under the light microscope.While the observation group had glomerular lesions,and accompanied by local interstitial fibrosis tubular atrophy.Under immunofluorescence,the expression of TIN-ag symptoms in the renal tissue system of the control group was clear,and the expression in the observation group was relatively weak.The immunofluorescence absorbency（A） of two groups：4.72（3.01,10.63） in the observation group and 21.79（8.17,35.07） in the control group,and the difference was statistically significant（P〈0.05）.There was no significant difference in immunofluorescence absorbance between primary focal segmental glomerulosclerosis（FSGS）,IgA nephropathy,membranous nephropathy（MN） and lupus nephritis（LN）（P〉0.05）.Conclusion The expression of TIN-ag in renal tissue of patients with non-minimal lesion CKD is significantly lower than that of CKD patients with minimal lesion.Therefore,TIN-ag has great exploration value in physiological and pathological significance of kidney.