肾小球疾病患者尿沉渣足细胞分子podocin和podocalyxin分析

目的：以ELISA法检测尿沉渣足细胞podocin,podocalyxin排泌并观察其与不同肾小球疾病的关系。方法：共收集我院自2010年5月～8月以来行肾活检证实为肾小球疾病的患者,收集其临床资料,并以ELISA法检测尿沉渣足细胞分子podocin,podocalyxin。结果：共40个患者,男15例,女25例,平均年龄（38.27±16.33）岁,增殖性肾小球疾病患者19例：IgA肾病10例,新月体性肾炎2例,IgM肾病2例,Ⅳ（A/G）型狼疮性肾炎5例;非增殖性肾小球疾病患者19例：微小病变型（MCD）5例,局灶节段硬化性肾小球肾炎（FSGS）8例,膜性肾病（MN）6例,另原发性肾淀粉样变性2例,对照健康自愿者10例。尿podocin分子排泌在正常对照组最低,在增殖性肾小球疾病和非增殖性肾小球疾病间差异无统计学意义（P〉0.05）,增殖性肾小球疾病尿podocin排泌高于肾淀粉样变性患者（P〈0.05）。新月体肾炎的尿podocin排泌显著高于其他肾小球疾病（P〈0.05）,后依次FSGS,IgA肾病,狼疮性肾炎,MN,IgM肾病,MCD;尿沉渣podocalyxin排泌在正常对照组最低,而增殖性肾小球肾炎和非增殖性肾小球肾炎间差异无统计学意义（P〉0.05）。新月体肾炎尿podocalyxin排泄量最高,其后依次为FSGS,IgA肾病,MN,狼疮性肾炎,MCD,IgM肾病,以肾淀粉样变性最低。尿podocalyxin与podocin呈正相关,尿podocin与血C3呈负相关。结论：ELISA法检测尿沉渣足细胞分子检测可对肾小球疾病患者的肾病理类型提供参考,以正常人尿podocin,podocalyxin排泌最少,增殖性肾小球疾病和非增殖性肾小球疾病间差异无统计学意义,新月体性肾炎尿沉渣podocin及Podocalyxin高于其他疾病患者,FSGS患者的尿沉渣podocin及Podocalyxin排泌量也较多,肾淀粉样变性患者的尿沉渣podocin及Podocalyxin最低,血清C3与尿podocin的排泌呈负相关。

Urinary Sediment Podocin, Podocalyxin in the Patients with Different Glomerular Diseases

Objective：To investigate the urinary sediment podocin and podocalyxin in the patients with biopsy proven glomerulonephritis.Methods：Patients with biopsy proven glomerulonephritis were enrolled in this study from May to August in 2010.Clinical characteristics were collected.Urinary sediment podocin and podocalyxin were measured using ELISA.Results：We collected totally 40 patients （ 15 Males and 25 females）.The average age of these patients was 38.27±16.33 years old.There were 19 proliferative glomerulonephritis cases （IgAN： 10 cases;Crescentic glomerulonephritis： 2 cases;IgMN：2 cases;Lupus nephritis IV（A/G）： 5 cases）;19 non-proliferative glomerulonephritis cases（MCD： 5 cases;FSGS： 8 cases;MN：6 cases） and two patients with renal amyloidosis.10 healthy persons were enrolled as the control group.Results： Urinary podocin in the healthy person was the lowest.There was no significant difference in the urinary podocin between the proliferative glomerulonephritis group and the non-proliferative glomerulonephritis group（P0.05）.Urinary podocin in the proliferative glomerulonephritis group was higher than that in the renal amyloidosis group（P0.05）.The urinary podocin was increased significantly in the patients with crescentic glomerulonephritis as compared with the patients with other types of renal disease（P0.05）.Then the urinary podocin was gradually decreased in the order as FSGS,IgAN,MN,Lupus nephrits,MCD,IgMN.The urinary podocin in the patients with renal amyloidosis was the lowest among these patients.Urinary podocalyxin in the healthy person was the lowest.There was no significant difference in the urinary podocalyxin between the proliferative glomerulonephritis group and the non-proliferative glomerulonephritis group（P0.05）.However,urinary podocalyxin was the highest in the patients with crescentic glomerulonephritis as compared with the patients with other glomerular disease（P0.05）.Then the urinary podocalyxin was gradually decreased in the order as FSGS,IgAN,Lupus nephrits,MN,IgMN,MCD.The urinary podocalyxin in the patients with renal amyloidosis was the lowest among these patients.Urinary podocalyxin correlated positively to urinary podocin.Urinary podocin correlated negatively to serum C3.Conclusion：Measurement of urinary sediment podocyte molecules using ELISA help to diagnose glomerular disease.Urinary podocin and podocalyxin in the healthy persons was the lowest.There was no significant difference between the proliferative glomerulonephritis group and the non-proliferative glomerulonephritis group.Urinary Podocin and Podocalyxin in the patients with crescentic glomerular nephritis were both the highest as compared with the patients with other types of glomerular disease.Urinary podocin and podocalyxin were also increased in the patients with FSGS.In the patients with renal amyloidosis,urinary podocin and podocalyxin were the lowest as compared with the patients with other glomerular disease.Urinary podocin correlated negatively to serum C3.