维生素D及其受体与肾盂输尿管连接部狭窄相关性的初步研究

目的初步分析维生素D及其受体与肾盂输尿管连接部狭窄(ureteropelvic junction obstruction,UPJO)发生的相关性。方法选择2016年3月1日至2016年10月31日上海交通大学医学院附属上海儿童医学中心小儿泌尿外科收治的因UPJO行离断式肾盂输尿管成形术的患儿为UPJO组(n=10),因肾脏肿瘤行肾与输尿管切除术的患儿为对照组(n=8)。收集两组术前血标本检测维生素D三项(25-羟维生素D 2、25-羟维生素D 3及总25-羟维生素D的含量)。取两组术中标本采用ELISA法,检测维生素D受体(vitamin D receptor,VDR)、转化生子因子(transforming growth factor-β,TGF-β)及钙黏蛋白E的含量。结果两组术前血标本中25-羟维生素D 2、25-羟维生素D 3及体内总25-羟维生素D的含量均无统计学差异(P>0.05)。UPJO组VDR、TGF-β、钙黏蛋白E的平均值分别为(771.6±70.57)ng/每克总蛋白,(131.0±10.33)ng/每克总蛋白及(125.5±10.98)ng/每克总蛋白;对照组分别为(2128±251.8)ng/每克总蛋白,(82.3±6.834)ng/每克总蛋白及(386.6±78.71)ng/每克总蛋白。两组UPJ标本中VDR、TGF-β、钙黏蛋白E水平的差异有统计学意义(P<0.05)。结论UPJO组VDR表达量显著低于对照组,提示VDR可能与UPJO发生相关,初步推测其机制可能是肾盂输尿管连接部VDR表达量减少引起TGF-β表达量明显升高,使得肾盂输尿管连接部的组织纤维化加重,进而导致或加重UPJO。

A preliminary study on the relationship between vitamin D and its receptor and ureteropelvic junction obstruction

Objective To explore the correlation between UPJO and vitamin D and its receptor.Methods 10 cases of children who underwent UPJO disconnection pyeloplasty were divided into UPJO group.8 children who underwent renal and ureterectomy for renal tumors were enrolled in the control group.The preoperative contents of 25 hydroxyvitamin D 2,25 hydroxyvitamin D 3 and total 25 hydroxyvitamin D were detected.VDR,TGF-βand cadherin E content were detected by ELISA staining.The results of the test were used t test for statistical analysis,compare the differences between two groups,and analyze the correlation between vitamin D and its receptor and UPJO.Results there was no significant difference between the two groups in the detection of vitamin D three items before operation.The mean values of VDR,TGF-βand cadherin E in UPJO group were 771.6±70.57 ng/g,131.0±10.33 ng/g and 125.5±10.98 ng/g respectively.The corresponding mean values in tumor control group were 2128±251.8,82.3±6.834 and 386.6±78.71 ng/g respectively.The data of two groups were tested by t-test(P<0.05).The expression of VDR and cadherin E in UPJO group was significantly lower than that in control group.TGF-βwas significantly higher than that of the control group.Conclusion The expression of VDR receptor in UPJO group was significantly lower than that in control group,suggesting that VDR may be related to UPJO.The initial mechanism may be the decrease in the expression of VDR at UPJ,causing a significant increase in the expression of TGF-β,which aggravates the tissue fibrosis at the UPJ,resulting in or aggravating UPJO.