肾组织内皮素受体A、B在老年糖尿病肾病发展中的作用研究

发布时间：2018-02-12 05:24

本文关键词： 糖尿病肾病肾组织内皮素受体老年人　出处：《中国现代医学杂志》2017年15期 　论文类型：期刊论文

【摘要】：目的探讨肾组织中内皮素受体A、B(ETAR、ETBR)表达变化在老年糖尿病肾病发展中的作用。方法选取2015年1月-2016年6月该院收治的糖尿病肾病老年患者34例,根据糖尿病肾病病理分型分为:糖尿病肾病Ⅰ级(D1组10例),Ⅱ级(D2组12例),Ⅲ级(D3组12例);选取同期在该院行肾肿瘤切除术后远离肾肿瘤的正常组织为对照组(10例)。免疫组织化学检测ETAR、ETBR的表达量;免疫荧光双染法定位ETAR、ETBR在肾组织的分布部位。收集生化检测指标,计算肾小球硬化率,进行相关性分析。结果 D3组尿蛋白水平高于D2和D1组,差异有统计学意义(P0.05);D3组肾小球滤过率(GFR)和白蛋白(Alb)与D1组比较差异有统计学意义(P0.05);D3组和D2组肾小球硬化率均高于D1组,差异有统计学意义(P0.05)。糖尿病肾病各组ETAR、ETBR表达量均高于对照组,差异有统计学意义(P0.05);对照组ETAR表达量少于ETBR,随着病情加重糖尿病肾病患者肾组织中ETAR表达量逐渐增加,组间比较差异有统计学意义(P0.05);D2组ETBR表达量最高,与D1组和D3组比较差异无统计学意义(P0.05);ETAR/ETBR在各组比较差异有统计学意义(P0.05)。ETAR在肾小管近端和远端均存在表达,ETBR主要表达于肾小管近端。糖尿病肾病患者肾组织中ETAR表达量与病程、尿蛋白水平、肾小球硬化率(ROG)呈正相关;ETBR表达量与病程呈负相关;ETAR/ETBR比值与病程、尿蛋白水平及ROG呈正相关,与Alb、GFR呈负相关。结论老年糖尿病患者肾组织中ETAR、ETBR表达量增加,ETAR/ETBR值倒置与病情发展呈正相关。
[Abstract]:Objective to investigate endothelin receptor A in renal tissue, B (ETAR, ETBR) expression in the development of diabetic nephropathy in elderly patients in 34 elderly patients with diabetic nephropathy. Methods from January 2015 -2016 year in June the hospital treated patients with diabetic nephropathy, according to pathological type is divided into: diabetic renal disease grade (10 cases of group D1) (II, 12 cases in D2 group (D3 group), 12 cases of grade III); normal tissues were selected in the hospital for renal tumor resection from renal tumors as the control group (10 cases). The immunohistochemistry of ETAR, the expression of ETBR; immunofluorescence double staining method of ETAR positioning, distribution location of ETBR in renal tissue. Collection of biochemical indicators, calculated the rate of glomerulosclerosis, correlation analysis. The results of urine protein level of D3 group was higher than that of D2 and D1 group, the difference was statistically significant (P0.05); group D3, glomerular filtration rate (GFR) and albumin (Alb) has increased significantly compared with the D1 group (P0.05 D3); The rate of glomerulosclerosis group and D2 group were higher than D1 group, the difference was statistically significant (P0.05). Diabetic nephropathy group ETAR, the expression of ETBR was higher than that of control group, the difference was statistically significant (P0.05); the control group the expression of ETAR was less than ETBR, with ETAR expression gradually increased exacerbations in patients with diabetic nephropathy in renal tissue, there were significant differences between the groups (P0.05); the D2 expression of ETBR was highest in group, no statistical significance compared with D1 group and D3 group (P0.05); ETAR/ETBR was statistically significant difference (P0.05).ETAR is expressed in the proximal and distal renal tubular, ETBR mainly expressed in renal tubular near the end. The amount and duration of ETAR expression in renal tissue of patients with diabetic nephropathy, proteinuria, glomerular sclerosis rate (ROG) was positively correlated; the expression of ETBR was negatively related to the amount and duration; the ratio of ETAR/ETBR and duration, positive urine protein level and ROG, Alb and GFR. Conclusion the expression of ETAR and ETBR in renal tissues of elderly patients with diabetes increased, and the inversion of ETAR/ETBR was positively correlated with the development of the disease.

【作者单位】：海南省琼海市人民医院肾内科;
【分类号】：R587.2;R692.9

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