弥漫增生型狼疮性肾炎肾组织中细胞凋亡的研究

目的探讨狼疮性肾炎(LN)肾组织中细胞凋亡程度及其与病理组织学及临床参数改变间的关系。方法对25例Ⅳ型LN与12例IgA肾炎(IgAN)、4例系膜增生性肾炎(MsPGN)、3例急性链球菌感染后肾炎(APSGN)的肾活检组织采用原位末端标记法检测凋亡细胞，免疫组化ABC法(PCNA)检测增殖细胞。结果狼疮性肾炎较其他类型增殖性肾小球肾炎肾组织中凋亡细胞数低，而PCNA阳性细胞数/TdT阳性细胞数的比值(P/T值)最高；肾小球及小管间质的P/T值均与肾组织病变慢性化指数相关，为r=0.4983(P=0.0132)，r＝0.8399(P＜0.001)，r=0.6614(P=0.0033)；肾小球及肾小管的P/T值与24h尿蛋白定量成正相关，为r＝0.8554(P＜0.001)，=0.7134(P=0.001)；与Ccr成负相关，为r=-0.4880(P=0.0133),r=-0.7229(P=0.001)；肾小管的P/T值与Scr成正相关,r=0.4107(P=00414)。结论增殖性狼疮性肾炎存在细胞凋亡不足，显著的细胞增殖而无相应的凋亡增强可能与狼疮性肾炎呈现慢性进展有关。     

量子点荧光标记技术与免疫组织化学染色检测泌尿系统肿瘤组织特异性抗原表达的效果比较

目的 通过比较量子点(QDs)荧光标记技术与免疫组织化学(IHC)染色检测膀胱癌组织标本中CD44v6抗原和前列腺癌组织标本中前列腺干细胞抗原(PSCA)的效果,观察该标记技术的敏感性.方法 采用QDs荧光标记技术和IHC染色检测80例膀胱癌组织中的CD44v6抗原和40例前列腺癌组织中PSCA的表达.结合肿瘤临床分期分级,评估两种标记方法得出的肿瘤分级.结果 CD44v6抗原在膀胱癌组织中的表达与肿瘤的分级(QDs:r=-0.345,P=0.002;IHC:r=-0.392,P＜0.001)和分期(QDs:r=-0.243,P=0.03;IHC:r=-0.306,P=0.006)呈负相关,两种方法的Kappa值为0.931 (P＜0.001),说明两种标记方法对膀胱癌组织中CD44v6抗原的检测结果具有一致性.另外,PSCA在前列腺癌组织中的表达与肿瘤的Gleason评分(QDs:r=0.732,P ＜0.001;IHC:r =0.683,P＜0.001)和分期(QDs:r=0.514,P=0.001;IHC:r=0.432,P=0.005)呈正相关,两种方法的Kappa值为0.874(P ＜0.001),说明两种标记方法对前列腺癌组织中PSCA的检测结果具有一致性.结论 QDs荧光标记具有良好的敏感性,该技术在泌尿系肿瘤研究领域具有广阔前景,为肿瘤诊治水平奠定了良好的基础.     

三磷酸腺苷生物发光法在卵巢癌体外化疗药物敏感试验中的应用

为探讨新鲜卵巢癌标本化疗药物敏感试验结果与临床疗效的相关性,采用三磷酸腺苷生物发光法(ATP-CVA),用液闪计数仪对25份新鲜卵巢癌组织标本进行药敏检测.结果显示:在ATP浓度为10-9～10-5mol/ml时,ATP标准品与发光计数值呈一线性关系,Y=1.48X+15.03,相关系数为0.9963;所检测的25份标本中成功22份,试验的可评价率为88% ,其敏感性为85.7%(12/14),特异性为83.3%(5/6),阳性预测值为92.3%(12/13),阴性预测值为71.4%(5/7),总的预测准确率为85%(17/20).上述结果表明,本药敏试验结果的预测准确性较高,与临床疗效之间具有很好的相关性,值得进行更深入的研究.     

外源性ATP对大鼠移植胰腺的作用及机制

目的: 探讨外源性三磷酸腺苷(ATP)对大鼠移植胰腺的作用和机制. 方法: 建立SD大鼠同种异位全胰十二指肠移植模型,供体胰腺分别用肝素平衡盐液或肝素平衡盐添加ATP液进行低温(0～4℃)灌注并保存60 min后行移植手术,检测再灌注0, 1, 6, 12 h时血糖、脂肪酶、淀粉酶含量,同时检查胰腺组织病理学变化,ATP含量及凋亡、胀亡细胞百分数. 结果: ATP组胰腺组织结构损伤明显轻于对照组,ATP 6, 12 h组血糖、血清淀粉酶、脂肪酶含量明显低于同时间点对照组 (血糖,脂肪酶,P＜0.05;淀粉酶,P＜0.01),ATP 0, 1 h组胰腺组织ATP含量明显高于同时间点对照组(P＜0.01),ATP组各时间点胀亡细胞百分数明显小于同时间点对照组(0, 1, 6 h, P＜0.01;12 h, P＜0.05), ATP含量与胀亡细胞百分数明显负相关(r=-0.756, P＜0.01),与凋亡细胞百分数无明显相关. 结论: 外源性ATP对移植胰腺有保护作用,减少胰腺组织细胞胀亡的发生可能是其重要的保护机制.     

不同方法对医院发热门诊物体表面清洁消毒效果的观察

目的 探讨不同方法对发热门诊物体表面的清洁消毒效果,为选择合适的物体表面清洁消毒方法提供依据。方法 将发热门诊的高频接触物体表面分为对照组和观察组,分别采用含氯消毒液和过氧化氢消毒湿巾进行清洁消毒,采用荧光标记法、三磷酸腺苷生物荧光检测和微生物法对比两组荧光标记的清除率、三磷酸腺苷(adenosine triphosphate, ATP)生物荧光检测合格率和细菌菌落数合格率。运用SPSS 20.0软件,对组间数据采用χ²检验,以P<0.05为差异有统计学意义的差异性分析方法探究清洁消毒效果。结果 干预前后发热门诊高频接触物体表面清洁消毒后,含氯消毒液和过氧化氢消毒湿巾对荧光标记的完全清除率分别为80.47%和95.03%,两组差异有统计学意义(χ²=35.95,P<0.001);ATP生物荧光检测的合格率分别为93.33%和97.09%,两组差异无统计学意义(χ²=2.15,P=0.143);细菌菌落数合格率分别为98.65%和98.04%,两组差异无统计学意义(χ²=0.12,P=0....     

急性冠脉综合征病人生活质量的多因素分析

目的 探讨影响急性冠脉综合征(ACS)病人生活质量(QOL)的危险因素,从而为早期识别QOL较差的高危病人提供理论依据.方法 对403例ACS病人进行QOL测评,同时进行焦虑抑郁情绪测量及其他可能相关因素的收集.以QOL为因变量进行多重线性回归分析.结果 心肌梗死172例(42.6%),不稳定性心绞痛74例(57.3%).其中84例(20.8%)有焦虑情绪,43例(10.7%)有抑郁情绪,144例(35.7%)同时有焦虑和抑郁情绪.年龄(r=-0.237,P＜0.001),女性(r=-0.183,P＜0.001),焦虑情绪(r=-0.211,P＜0.001),抑郁情绪(r=-0.180,P＜0.001)与躯体健康呈独立负相关.年龄(r=-0.117,P=0.01)、焦虑情绪(r=-0.215,P＜0.001)、抑郁情绪(r=-0.169,P=0.004)与精神健康呈独立负相关,吸烟(r=0.157,P=0.001)与精神健康呈独立正相关.结论 高龄、女性、焦虑和/或抑郁情绪为ACS病人QOL差的危险因素.     

穿膜肽修饰的纳米颗粒抗胰腺癌的初步研究

目的 探究穿膜肽修饰的纳米颗粒介导的光动力学疗法(PDT)对胰腺癌SW1990细胞的杀伤作用.方法 将胰腺癌SW1990细胞分成4组,不光照不含光敏剂的细胞作为空白对照组,与细胞共孵育的游离Ce6组,NP/Ce6组及TAT-NP/Ce6组.首先分别制备出纳米颗粒TAT-NP/Ce6和NP/Ce6.利用流式细胞仪(FACS)检测各组被SW 1990细胞摄取的情况;荧光显微镜观察各组光照下在细胞内产生活性氧的情况;最后用MTT或活死染色法检测光照下各组对细胞的杀伤效果.结果 FACS结果显示各组分别被细胞摄取4h后,TAT-NP/Ce6组胞内荧光显著高于NP/Ce6组(P＜0.001),同时NP/Ce6组明显强于free Ce6组(P ＜0.001).荧光显微镜显示光照下纳米颗粒TAT-NP/Ce6组在细胞内产生活性氧明显强于其他各组(P ＜0.001).MTT法显示在每一Ce6浓度下光照时,TAT-NP/Ce6组对细胞的杀伤效果明显强于NP/Ce6 (P＜0.01),Ce6浓度为0.5μg/ml时,活死细胞染色法同样证明了对细胞的这种杀伤效果.结论 TAT肽修饰的纳米颗粒能有效增加胰腺癌细胞对其摄取,其介导的PDT杀伤胰腺癌细胞效果明显增强.     

体外传代培养对人视网膜色素上皮细胞免疫调控能力的影响

目的 研究体外传代培养对人类视网膜色素上皮(human retinal pigment epithelialium,HRPE)细胞免疫调控能力的影响.方法 建立HRPE细胞与异体淋巴细胞共培养系统,采用流式细胞术检测原代及传代HRPE细胞(第1、2、3、4、5、6代)Fas表达以及诱导异体淋巴细胞凋亡能力的差异.结果 HRPE与淋巴细胞体外共培养时,HRPE细胞Fas表达随着传代逐渐减弱,Fas表达与传代代数呈负相关(阳性细胞率r=-0.859,P＜0.001;平均荧光强度r=-0.880,P＜0.001),HRPE细胞诱导淋巴细胞凋亡随着传代逐渐减弱,淋巴细胞凋亡率与传代代数呈负相关(r=-0.838,P＜0.001),共培养时传代HRPE细胞Fas表达迅速下降,至第3代与第4代间Fas表达差异无统计学意义(P＞0.05),共培养时传代HRPE细胞诱导淋巴细胞凋亡率迅速下降,至第3代与第4代问淋巴细胞凋亡率差异无统计学意义(P＞0.05).结论 体外传代培养的HRPE细胞,传代数越大细胞变异越大,第3代后细胞的免疫调控能力明显下降.     

生物介质中MN9202检测方法的建立及其应用

目的:建立生物介质中1,4-二氢-2,6-二甲基-4-(3硝基苯基)-3,5-吡啶二甲酸甲戊酯(MN9202)的高效液相色谱检测方法. 方法:分别以细胞和大鼠血浆作为生物样本,用乙醚对含药Caco-2细胞裂解液及血浆样品进行预处理,用反相高效液相色谱法分析生物样本中的原形药物的浓度. 结果:在选定的色谱条件下,MN9202和干扰物质能够实现较好的分离,测定细胞样品的工作曲线回归方程为Y=0.0048X 0.0592,r=0.9997,n=7 (P《0.01),线性范围为20～500 mg/L. 测定血浆样品的工作曲线回归方程为Y=0.0058X 0.1468,r=0.9998,n=7(P《0.01),线性范围为20～500 mg/L. 结论:所建立的分析方法简便、稳定、灵敏、准确,可用于生物介质中MN9202的浓度检测.     

荧光定量RT-PCR法检测胃癌患者腹腔洗出液中CEA-mRNA含量的临床意义

目的探讨用荧光定量RT-PCR法检测胃癌患者腹腔洗出液中癌胚抗原mRNA(CEA-mRNA)含量的临床意义.方法采用荧光定量RT-PCR法检测98例胃癌患者及10例胃溃疡患者(对照组)手术中病灶切除前后腹腔洗出液中CEA-mRNA的含量,对不同病期及切除前后所测得的CEA-mRNA含量进行统计分析.结果本法可检测的下限约为10copies/ml,上限约为1.0×108copies/ml.检测所得荧光信号基线的循环数(CT值)与CEA-mRNA拷贝数对数值的相关系数为-1.0,错误率为0.0731.对照组腹腔洗出液CEA-mRNA的含量少于10copies/ml.胃癌患者腹腔洗出液中CEA-mRNA的含量病灶切除前为(0.0～5.62)×106copies/ml,几何均数为(172.11±63.07)copies/ml;切除后(256.4～4.67)×107copies/ml,几何均数为(606.32±76.21)copies/ml,两组的差别有显著性意义(P=0.008);切除前Ⅰ a Ⅰ b期与Ⅱ期、Ⅱ期与Ⅲa Ⅲb期、Ⅲa Ⅲb期与Ⅳ期比较,其CEA-mRNA含量的差别均有显著性意义(P=0.007、0.015、0.027);同样,切除后各期比较,其差别也均有显著性意义(P=0.004、0.012、0.023).切除前后未侵及浆膜与侵及浆膜者比较,其CEA-mRNA含量的差别有显著性意义(P=0.0008、0.0007);切除前后有淋巴结转移者与未转移者比较,其CEA-mRNA含量的差别有显著性意义(P=0.045、0.044);不同分化程度者切除前后其CEA-mRNA含量的差别均无显著性意义(P=0.17、0.12).结论荧光定量RT-PCR法检测腹腔洗出液中CEA-mRNA的含量有较好的线性范围,在临床应用中,对病期的确定、预后的估计以及术后的治疗方案制定均有一定的价值.     

An adenosine triphosphate bioluminescence assay for detecting the number of living cells]

The method for detecting the number of living cells was studied. Using an adenosine triphosphate (ATP) bioluminescence assay, the present authors reported a perfect linear relationship between lg ATP concentrations and lg luminescence counts (r = 0.9963) as well as a relationship between lg number of cells and lg ATP luminescence counts (r = 0.9922). The detectable cells ranged from 10(2) to 10(6) cells/ml, the coefficients of variation 1-3%. This method is simple, accurate and sensitive and has a high reproducibility.     

卵巢癌药敏试验的微量法研究

目的　探讨微量检测 ATP在卵巢癌药敏试验中应用的可行性。方法　对 35例新鲜卵巢癌组织标本进行药敏试验 ,应用 Victor 2多功能检测仪微量检测 ATP值。结果　 1Victor 2多功能检测仪微量检测 ATP标准品与发光值的关系 ,在 ATP浓度为 10 - 9～ 10 - 5m ol/ml时 ,显示极好的线性关系 ,直线方程为 Y =0 .892 X +10 .2 5 7,相关系数 r=0 .998(P<0 .0 1)。 2微量检测 ATP的变异系数平均为 7.3%。 3微量检测 ATP进行药敏试验 ,敏感性 92 .0 % ,特异性 70 .0 % ,预测准确率为 87.1%。结论　应用 Victor 2多功能检测仪微量检测 ATP进行药敏试验 ,方法稳定 ,实验成本降低 ,更为简便、快速 ,误差小 ,值得推广和普及     

慢性乙型肝炎病毒感染患者临床和肝脏病理特征分析

目的了解慢性乙型肝炎病毒（HBV）感染者肝脏病理特征,探讨其与血清学关系。方法采用回顾性分析方法,收集114例慢性HBV感染者,所有患者均行肝穿刺组织活检,同时检测肝功能、HBeAg和HBVDNA定量,分析肝组织炎症分级（G）和纤维化分期（S）与HBeAg状态、HBVDNA水平的关系。结果114例患者中,113例（99．12％）患者肝组织发生病理改变,53例（46．49％）患者肝脏炎症分级和／或纤维化分期≥G2／$2。HBeAg阴性和HBeAg阳性患者年龄、血小板计数、HBVDNA水平差异有统计学意义,2组炎症分级差异无统计学意义（P〉0．05）,纤维化分期差异有统计学意义（P〈0．05）,Spearman相关性分析显示HBeAg与炎症分级和纤维化分期无关（r=-0．006,r=-0．147,P〉0．05）。HBVDNA定量分层分析,≤5lg拷贝／ml组、6—7lg拷贝／ml组和≥8lg拷贝／ml组HBeAg阴性患者分别为47例（83．93％）、8例（19．15％）和0例,≤5lg拷贝／ml组和其余2组比较有统计学差异（P〈0．05）。3组肝组织学≥G2／S2分别为33例（58．93％）、18例（42．86％）、2例（12．5％）,≥8lg拷贝／ml组和其余2组比较差异有统计学（P〈0．05）。Spearman相关性分析显示HBVDNA水平与纤维化分期负相关（r=-0．279,P〈0．05）,与炎症分级无关（r=-0．091,P〉0．05）。结论绝大部分慢性乙型肝炎病毒感染者有不同程度肝组织病理变化;HBeAg阴性患者较HBeAg阳性患者有更为严重肝脏病理变化,HBeAg状态与肝脏炎症和纤维化程度无关,HBVDNA水平和肝脏纤维化程度相关。     

Effect of temperature on the activation of myocardial KATP channel in guinea pig ventricular myocytes: a pilot study by whole cell patch clamp recording

Background The myocardial ATP sensitive potassium channel (K(ATP) channel) has been known for more than two decades, the properties of this channel have been intensively investigated, especially the myocardial protection effect by opening this channel. Numerous studies, including hypothermic, using K(ATP) agonists to achieve a hyperpolarizing cardioplegic arrest, have shown a better myocardial protection than potassium arrest. However, there is no evidence showing that K(ATP) channel could be opened by its agonists under profound hypothermia. We investigated the effect of temperature on activation of myocardial K(ATP) channel by nicorandil.Methods Isolated ventricular myocytes were obtained by collagenase digestion of the hearts of guinea pigs and stored in KB solution at 4&#730;C. With a steady ground current, the myocytes were perfused with 1 mmol/L nicorandil until a steady IK(ATP) occurred. Then the cells were perfused with 1 mmol/L nicorandil plus 1 &micro;mol/L glybenclamide. Currents signals were recorded on whole cells using patch clamp technique at several temperatures. The temperature of the bath solution around myocytes was monitored and was controlled at 4&#730;C, 10&#730;C, 20&#730;C, 25&#730;C and 35&#730;C respectively. About 10 cells were tested at each temperature, the cells were considered useful only when the outward current could be induced by nicorandil and blocked by glybenclamide. All data were analyzed using Graphpad PRISM 3.0 (Graphpad, San Diego, CA, USA). Nonlinear curve fitting was done in Clampfit (Axon) or Sigmaplot (SPSS). Results At 4&#730;C, 10&#730;C, 20&#730;C, 25&#730;C and 35&#730;C, the time needed to open the myocardial K(ATP) channel was (81.0±0) minutes, (50.5±11.7) minutes, (28.8±2.3) minutes, (9.4±10.2) minutes and (2.3±1.0) minutes respectively (P=0.003). The linear relationship between temperature and time needed to open the channel was y (min) = (4348.790－124.277x)/60, where y (min) is time needed to open K(ATP) channel, x is temperature, correlation coefficient r =－0.942 (P=0.00), regression coefficient b =－124.277 (P=0.00). The current densities among different temperatures were statistically different (P=0.022), the current density was greater after the activation of K(ATP) channel at higher temperatures. The lower the temperature, the fewer cells in which K(ATP) channels could be opened. At 4&#730;C, only one cell in which the K(ATP) channel could be opened, took a quite long time (81 minutes) and the I-V curve was quite untypical.Conclusions K(ATP) channel activated by nicorandil is temperature dependent and the temperature linearly related to time needed to open K(ATP) channel; the lower the temperature, the longer the time needed to open channel and the smaller the current density. At profound hypothermia, it is difficult to activate K(ATP) channels.     

小剂量外照射对小白鼠自细胞数、骨髓象及CFU-GM的影响

小鼠X射线照射:0.05、0.25、0.5、0.75、1.0Gy后24小时检查外周血白细胞数、淋巴细胞绝对值、骨髓有核细胞计数和骨髓CFU—GM存活率。0.5Gy照射可引起白细胞总数和淋巴细胞减少。0.05Gy即可引起骨髓CFU—GM存活率明显降低。白细胞计数、淋巴细胞绝对值、骨髓有核细胞计数,CFU—GM存活率皆随照射剂量增加呈线性减低。     

系统性红斑狼疮患者外周血γδT细胞变化的临床意义

【目的】探讨系统性红斑狼疮（systemic lupus erythematosus,SLE）患者外周血中16T细胞的变化及临床意义。【方法】选取46例SLE患者（实验组）、18名健康人（对照组）,采用流式细胞分析仪分析技术检测其外周血中CD3^＋、γδT细胞绝对数及百分率。【结果】与健康组相比,SLE患者18T细胞绝对计数明显低于健康对照组（P〈0．01）,且其γδT细胞凋亡率显著高于健康对照组细胞凋亡率（P〈0．05）。活动期SLE患者叮6T细胞绝对数明显低于非活动期（P〈0．05）,且与红细胞沉降率（erythrocyte sedimentation rate,ESR）及SLE疾病活动指数（SLE disease activity index,SLEDAI）评分均呈负相关（r=-0．282,r=-0．378,P=0．028,P=0．037）,但与血红蛋白浓度呈正相关（r=0．287,P=0．006）。【结论】SLE患者外周血中γδT细胞数量下降,且与病情活动相关;γδT细胞数量下降的机制可能与凋亡增加有关。     

Correlation of lower respiratory tract inflammation with changes in lung function and chest roentgenograms in patients with untreated tropical pulmonary eosinophilia

Forty-one patients with untreated tropical pulmonary eosinophilia (TPE) were studied to determine whether there was any relationship between lower respiratory tract inflammation and either changes in lung function or abnormalities in chest roentgenograms. Total number of inflammatory cells in bronchoalveolar lavage (BAL) fluid, consisting of alveolar macrophages, lymphocytes, eosinophils and neutrophils had significant negative correlations with transfer factor (TLCO) (r = 0.519, p less than 0.001), transfer coefficient (KCO) (r = 0.312, p less than 0.05) and total lung capacity (TLC) (r = 0.352, p less than 0.05). The absolute count of eosinophils in BAL fluid had a significant negative correlation with TLCO (r = 0.430, p less than 0.01) and KCO (r = 0.300, p = 0.05), but not with forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) or TLC. However, the absolute count of alveolar macrophages had a significant negative correlation with FVC (r = 0.343, p less than 0.05), FEV1 (r = 0.341, p less than 0.05) and TLC (r = 0.305, p less than 0.05), but not with TLCO or KCO. The total number of lymphocytes had a negative correlation with TLC (r = 0.315, p less than 0.05). There was no correlation between the types of cells recovered in BAL fluid and changes in chest radiographs as assessed by the ILO classification for occupational lung diseases. These data suggest that there may be a dissociation of pulmonary pathophysiological changes produced by different inflammatory cells in the lower respiratory tract. Macrophages and lymphocytes may produce more harm to the lung, as evidenced by significant negative correlations of these cells with lung volumes.     

乙酰甲胆碱支气管激发试验剂量—反应曲线参数测定的研究

OBJECTIVE: To investigate the clinical value in the measurement of parameters of the dose-response curve (DRC) obtained after the methacholine challenge test. METHODS: Twenty-seven cases of cough variant asthma (CVA), 29 of mild asthma, 19 of moderate asthma, and 15 healthy volunteers underwent the methacholine challenge test. The dose-response curves were constructed. The following parameters were calculated: position (PC35sGaw), dose-response curve (DRS), ratio of the area under the curve to the logarithm of the maximal concentration (AUC/lg[Cmax]) and maximal response. RESULTS: A plateau appeared in 11 cases among the healthy subjects, while a plateau appeared only in 2 cases of CVA and 2 of asthma. There were no significant differences among the asthmatic groups in the measurements of PC35sGaw and AUC/lg[Cmax] (geometric mean PC35sGaw: mild asthmatics = 0.369, moderate asthmatics = 0.251, cough variant asthmatics = 0.547), AUC/lg[Cmax] was significantly greater in the asthmatic groups than in the normal group [AUC/lg [Cmax](mean +/- s): mild asthmatics = 24.7 +/- 4.7, moderate asthmatics = 26.6 +/- 4.3, cough variant asthmatics = 25.6 +/- 3.7, normal subjects = 15.5 +/- 4.3, P < 0.01]. DRS of moderate asthmatics was significantly greater as compared with cough variant asthmatics (geometric mean DRS: mild asthmatics = 30.761, moderate asthma-tics = 59.020, cough variant asthmatics = 19.231, P < 0.05), but there was no difference between the other groups. PC35sGaw was negatively correlated with DRS (r = 0.866, P < 0.001) and with AUC/lg[Cmax] (r = 0.502, P < 0.001). CONCLUSION: Four parameters of DRC obtained after the methacholine challenge represent airway sensitivity and reactivity respectively. The parameters of DRC of asthmatic patients are different from those of normal subjects. The sensitivity is related to the reactivity, but they are not completely parallel with each other.     

黏附分子CD146在IgA肾病肾小管的表达及临床意义

目的 探讨黏附分子CD146在IgA肾病肾小管上皮细胞的表达及其与临床指标之间的关系. 方法 应用免疫组化法检测44例IgA肾病肾穿刺活检组织中CD146的表达情况,收集性别、年龄、血压、24 h尿蛋白、血肌酐等临床指标,对肾间质纤维化进行分度,计算肾小球硬化指数,分析各项指标与CD146表达的关系. 结果 CD146阳性着色主要见于肾小管上皮细胞,在小管周围微血管内皮细胞、平滑肌细胞亦可见.CD146在肾小管上皮细胞的表达男性患者强于女性患者(Z=-2.096,P=0.036),高血压患者、血肌酐增高患者及血甘油三酯增高患者CD146表达水平分别高于血压正常者、血肌酐正常者及血甘油三酯正常者(Z=-2.738、-2.166、-2.313,P=0.006、0.030、0.021).相关性分析发现CD146在肾小管上皮细胞的表达与24 h尿蛋白(r=0.381,P=0.011)、肾小球硬化指数(r=0.410,P=0.006)、间质纤维化程度(r=0.311, P=0.040)之间均有正相关性.结论 CD146分子参与了肾间质纤维化过程.