原发性肾病综合征患者尿液中podocalyxin、 nephrin的表达及意义

Expression and significance of podocalyxin and nephrin in urine of patients with primary nephrotic syndrome

目的探讨不同病理类型的原发性肾病综合征患者尿中podocalyxin、nephrin的表达及意义。方法将80例原发性肾病综合征患者,按照病理分为微小病变性肾病(MCN)组22例、系膜增生性肾小球肾炎(MsPGN)组11例、膜性肾病(MN)组36例、局灶性节段性肾小球硬化(FSGS)组11例,另设20例健康人为对照组。通过酶联免疫吸附法检测各组尿中podocalyxin、nephrin的表达,并分析其与24小时尿蛋白、血清白蛋白、血脂、肌酐的相关性。结果FSGS组尿podocalyxin、nephrin高于其他肾病综合征组和正常对照组( P <0.05),其他肾病综合征组高于正常对照组( P <0.05);MsPGN组尿podocalyxin、nephrin低于其他肾病综合征组( P <0.05),其在MCN、MN组表达差异无统计学意义( P >0.05);不同病理类型肾病综合征组尿podocalyxin、nephrin的表达与血清白蛋白呈负相关,与24小时尿蛋白、血脂、肌酐水平呈正相关( P 均<0.05)。结论尿podocalyxin、nephrin的表达水平与肾病综合征病理类型及疾病严重程度相关,可作为判断肾病综合征病理类型和预后的参考指标。

ObjectiveTo investigate the expression and significance of podocalyxin and nephrin in urine of patients with different pathological types of primary nephrotic syndrome. MethodsAccording to pathology,80 patients with primary nephrotic syndrome were divided into minimal change nephropathy(MCN) group(22 cases),mesangial proliferative glomerulonephritis(MsPGN) group(11 cases),membranous nephropathy(MN) group(36 cases) and focal segmental glomerulosclerosis(FSGS) group(11 cases).In addition,20 healthy people were selected as control group.And then,the expression of podocalyxin and nephrin in urine was detected by enzyme-linked immunosorbent assay,and its correlation with 24-hour urinary protein,serum albumin,blood lipid and creatine was analyzed. ResultsThe urinary podocalyxin and nephrin in the FSGS group were higher than those in other nephrotic syndrome groups and the control group( P <0.05),while those in other nephrotic syndrome groups were higher than those in the control group( P <0.05).The urinary podocalyxin and nephrin levels in MsPGN group were lower than those in other nephrotic syndrome groups( P <0.05),and there was no statistically significant difference in the expressions of podocalyxin and nephrin between the MCN group and the MN group( P >0.05).The expression of urinary podocalyxin and nephrin in different pathological types of nephrotic syndrome was negatively correlated with serum albumin,and positively correlated with 24-hour urinary protein,blood lipid and creatine level(all P <0.05). ConclusionThe expression levels of urinary podocalyxin and nephrin are related to the pathological type and severity of nephrotic syndrome,which can be used as a reference index to judge the pathological type and prognosis of nephrotic syndrome.