上皮细胞转分化与IgA肾病临床病理的相关性分析

目的：探讨上皮细胞转分化与IgA肾病临床病理的相关性。方法选取2011年1月至2013年12月在新桥医院肾内科肾活检确诊为IgA肾病患者168例，根据免疫组织化学染色分为转录因子（Snail）、平滑肌肌动蛋白‐a（a‐SMA）高表达组（A组，117例）和Snail、a‐SMA低表达组（B组，51例），并对两组患者年龄、性别、病程、体质量指数（BMI）、生化指标（肌酐、尿素氮、三酰甘油、24h尿蛋白定量、总胆固醇、血清清蛋白、血清总蛋白、血糖）及病理情况进行统计学比较。结果A组患者病程、BMI与B组差异均有统计学意义（P＜0．05）。A组肌酐、尿素氮、三酰甘油、24h尿蛋白定量与B组差异均有统计学意义（P＜0．05）。B组病理分级多为Ⅰ、Ⅱ、Ⅲ级，而A组病理分级多在Ⅳ、Ⅴ级，病理分级Ⅳ和Ⅴ级IgA肾病患者Snail、a‐SMA高表达的比例明显高于Ⅰ、Ⅱ级（40．2％vs．9．4％），两组间比较差异有统计学意义（P＜0．05）。结论IgA肾病患者Snail、a‐SMA表达水平与24h尿蛋白定量、肾功能损害相关，Snail、a‐SMA高表达者Lee氏分级较差。

The relationship between epithelial-mesenchymal transition and clinic pathology of IgA nephropathy

Objective To analyze the correlation between the epithelial‐mesenchymal transition and the clinicopathologic features of IgA nephropathy .Methods A total of 168 patients diagnosed as IgA nephropathy by renal biopsy in Xinqiao hospital from Janu‐ary 2011 to December 2013 were divided into high expression of dual‐positive Snail and a‐SMA group (Group A ,117 cases) and low expression of dual‐positive Snail and a‐SMA group (Group B ,51 cases) according to results of immunohistochemical method .The clinical parameters (age ,gender ,course of disease ,BMI and chemical indicators) and renal pathology grade were compared by statis‐tical analysis .Results There were difference between group A and group B in the course of disease and BMI(P<0 .05) .There were differences between group A and group B in the incidences of creatinine ,blood urea nitrogen ,serum triglycerides and 24‐hour urine protein amount (P<0 .05) .The percentage of Lee′s grade Ⅰ ,Ⅱ ,Ⅲ in group B was significant ,while percentage of Lee′s gradeⅣ + Ⅴin group A was significant .The expression of Snail and a‐SMA in grade Ⅳ + Ⅴ was more than that in grade Ⅰ + Ⅱ (40 .2%vs .9 .4% ) ,and the difference between two groups was statistically significant (P< 0 .05) .Conclusion The expression of Snail and‐SMA were related with 24‐hour urine protein amount and kidney function in IgA nephropathy ;and Lee′s grade was severe in patients with high expression of Snail and‐SMA .