ZO-1和occludin表达水平与慢性肾小球肾炎患者肾功能的关系

Relationship between expression levels of ZO-1,occludin and renal function in patients with chronic glomerulonephritis

目的 探究闭锁小带蛋白1(ZO-1)、闭锁蛋白(occludin)表达水平与慢性肾小球肾炎患者肾功能的关系。方法 选取2017年6月-2019年9月于中国医科大学附属盛京医院就诊的经皮肾脏穿刺手术的慢性肾小球肾炎患者102例为研究组,根据患者肾小球滤过率(eGFR)水平将其分为早期肾功能损害组50例,中期肾功能损害组38例,晚期肾功能损害组14例,另取30例于本院泌尿外科肾癌手术患者的癌旁正常肾组织为对照组。比较研究组和对照组一般资料及ZO-1、occludin蛋白表达水平。采用免疫组织化学法检测ZO-1、occludin蛋白水平。Pearson法分析慢性肾小球肾炎患者ZO-1、occludin蛋白表达水平之间的相关性;利用受试者工作特征曲线(ROC)评价ZO-1、occludin水平对慢性肾小球肾炎患者预后不良的预测价值。结果 慢性肾小球肾炎患者肾组织ZO-1、occludin蛋白表达水平均明显低于对照组患者,差异有统计学意义(P均<0.05);随着慢性肾小球肾炎患者肾功能受损加重,ZO-1、occludin蛋白水平呈降低趋势(P均<0.05);病情缓解或无进展慢性肾小球肾炎患者ZO-1、occludin蛋白水平均明显高于发展为慢性肾衰竭患者,差异有统计学意义(P均<0.05);慢性肾小球肾炎患者ZO-1、occludin蛋白水平之间呈正相关(r=0.515,P<0.05);ROC结果显示,ZO-1、occludin预测慢性肾小球肾炎患者预后不良的曲线下面积(AUC)分别为0.817、0.815,对应的灵敏度分别为94.00%、75.00%,特异度分别为53.33%、81.11%;二者联合预测慢性肾小球肾炎患者预后不良的AUC为0.906,灵敏度为96.00%,特异度为76.18%。结论 ZO-1、occludin表达水平随慢性肾小球肾炎患者肾功能受损加重而降低,且对患者预后不良有一定的预测价值。

Objective To explore the relationship between the expression of zonula occludens-1(ZO-1)and occludin and renal function in patients with chronic glomerulonephritis.Methods A total of 102 patients with chronic glomerulonephritis undergoing percutaneous renal biopsy in our hospital from June 2017 to September 2019 were selected as the study group.According to the level of estimated glomerular filtration rate(eGFR),they were divided into early renal function damage group(n=50),middle-stage renal function damage group(n=38)and advanced renal function damage group(n=14);another 30 cases of normal renal tissue adjacent to cancer of kidney in Urology Department of our hospital were taken as control group.The general data and expression levels of ZO-1 and occludin protein were compared between the study group and the control group.The levels of ZO-1 and occludin protein were detected by immunohistochemistry.Pearson method was used to analyze the correlation between the expression levels of ZO-1 and occludin in patients with chronic glomerulonephritis;receiver operating characteristic curve(ROC)was used to evaluate the predictive value of ZO-1 and occludin levels for poor prognosis in patients with chronic glomerulonephritis.Results The expression levels of ZO-1 and occludin in renal tissue of patients with chronic glomerulonephritis were significantly lower than those in control group(all P<0.05);the levels of ZO-1 and occludin protein decreased with the aggravation of renal function impairment in patients with chronic glomerulonephritis(P<0.05);the levels of ZO-1 and occludin protein in patients with remission or progressionfree chronic glomerulonephritis were significantly higher than those in patients with chronic renal failure(all P<0.05);there was a positive correlation between ZO-1 and occludin protein levels in patients with chronic glomerulonephritis(r=0.515,P<0.05);ROC results showed that the area under the curve(AUC)of ZO-1 and occludin in predicting poor prognosis of patients with chronic glomerulonephritis were 0.817 and 0.815,respectively;the corresponding sensitivity was 94.00% and75.00%,and the specificity was 53.33% and 81.11%,respectively;the AUC of the combined prediction for poor prognosis of patients with chronic glomerulonephritis was 0.906,the sensitivity was 96.00%,and the specificity was 76.18%.Conclusion The expression levels of ZO-1 and occludin decreased with the aggravation of renal function impairment in patients with chronic glomerulonephritis,and had certain predictive value for poor prognosis of patients.