IgA肾病肾小球微血管损伤和修复与中介素相关性研究

发布时间：2018-04-10 11:57

本文选题：肾小球肾炎 + IGA肾病　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:探讨IgA肾病(IgAN)患者肾小球微血管损伤情况及中介素(IMD)与IgAN肾小球微血管损伤和修复的相关性。方法:收集于我院肾内科首诊为原发性IgAN患者肾组织蜡块80例,正常肾组织15例为对照,免疫组织化学法检测肾小球IMD、CD31、VE-cadherin阳性表达;收集36例首诊为原发性IgAN患者血浆,31例健康体检中心健康志愿者血浆为对照,ELISA法检测IMD、VEGF含量,依据Lee氏分级、CKD分期分组,分析各指标的变化情况及相关性。结果:(1)不同Lee氏分级、CKD分期(Lee氏分级5级、CKD分期4期除外),IgAN患者肾小球CD31、IMD、VE-cadherin表达与对照组相比差异具有统计学意义(P0.01),各Lee氏分级、CKD分期肾小球CD31表达较对照组减少,肾小球IMD、VE-cadherin表达增加;CKD早期、中晚期各组IgAN患者血浆中IMD、VEGF含量与对照组相比差异具有统计学意义(P0.01),CKD早期、中晚期各组IMD、VEGF表含量均增加;(2)相关性分析:肾小球CD31表达与Lee氏分级呈负相关(r=-0.232,P0.05),肾小球IMD表达与Lee氏分级呈负相关性(r=-0.241,P0.05),与肾小球VE-cadherin呈正相关(r=0.417,P0.01);IgAN患者血浆VEGF与肾功能不全程度、BUN呈正相关(r=0.458、0.409,P均0.05),与ALB呈负相关(r=-0.532,P0.01)。结论:IgAN患者肾小球存在微血管损伤;IgAN患者肾小球IMD表达与IgAN Lee氏分级呈负相关,肾小球IMD表达随着IgAN病理程度加重而减少,肾小球IMD表达与VE-cadherin呈正相关,推测IMD在IgAN进展中可能参与血管保护与新生过程;血浆中IMD、VEGF在IgAN晚期增加明显,提示IMD、VEGF可能在IgAN进展中起到一定作用。
[Abstract]:Objective: to investigate the relationship between glomerular microvascular injury and IgAN glomerular microvascular injury and repair in patients with IgA nephropathy.Methods: 80 cases of primary IgAN and 15 cases of normal renal tissue were collected in our hospital. Immunohistochemical method was used to detect the expression of VE-cadherin in glomeruli.The plasma levels of IgAN were measured by Elisa in 36 patients with primary IgAN and 31 healthy volunteers. The changes and correlation of the indexes were analyzed according to the Lee's classification and CKD stages.Results (1) the expression of VE-cadherin in glomeruli of patients with different Lee's grade and Lee's grade 5 or Lee's grade of CKD with the exception of stage 4 was significantly higher than that of the control group (P 0.01). The expression of CD31 in glomeruli in all Lee's grade and CKD staging was lower than that in the control group, and the expression of VE-cadherin in glomeruli was significantly lower than that in the control group (P < 0.05).The expression of VE-cadherin in glomeruli increased in the early stage of CKD, and there was a significant difference in the level of VEGF in plasma between the middle and late groups of IgAN patients compared with the control group (P 0.01) at the early stage of CKD.Correlation analysis showed that the expression of CD31 in glomeruli was negatively correlated with Lee's grade, IMD expression in glomeruli was negatively correlated with Lee's grade, and was positively correlated with VE-cadherin in glomerular VE-cadherin.Bun was positively correlated with ALB, and negatively correlated with ALB.Conclusion there is a negative correlation between IMD expression and IgAN Lee grade in IgAN patients with glomerular microvascular injury. The expression of IMD in glomeruli decreases with the severity of IgAN. The expression of IMD in glomeruli is positively correlated with VE-cadherin.It is speculated that IMD may participate in the process of vascular protection and neovascularization in the progression of IgAN, and that the level of IMD in plasma is significantly increased in the late stage of IgAN, suggesting that IMD may play a role in the progression of IgAN.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692.31

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