血管内皮生长因子与血小板反应蛋白在肾间质纤维化中的表达研究

目的探讨肾病患者血管内皮生长因子（VEGF）与血小板反应蛋白（TSP）在肾间质纤维化中的阳性表达情况及其与CD34、CD40的相关性。方法选取本院2011年5月至2013年5月收治的不同类型肾病患者96例为研究对象,根据患者肾脏受损程度将其分为轻度损伤组38例,中度损伤组32例和重度损伤组26例,并选取30例健康体检者为对照组,分别应用免疫组化法对各组患者的VEGF、TSP、CD34、CD40阳性表达情况进行分析。结果 VEGF表达位置主要集中在足突细胞浆及肾小管上皮细胞中,TSP主要在肾小管上皮细胞浆中表达,在正常组织细胞中无阳性表达,CD34及CD40主要在肾小管周围毛细血管内皮细胞中表达。随着患者病情增加,TSP、CD40阳性表达率显著增加,而VEGF、CD34则显著减少,差异均有统计学意义（P〈0.05）。经单因素分析显示,TSP、CD40分别与肾间质纤维程度呈正相关,而VEGF、CD34与肾间质纤维化程度呈负相关。结论 TSP在肾质区及肾小管上皮细胞中表达的增强及VEGF在足细胞及肾小管上皮细胞中表达的减弱可能是引起肾间质纤维化发生及发展的重要因素。

Expression of vascular endothelial growth factor combined with platelet-reactive protein in renal interstitial fibrosis.

Objective To investigate the expression of renal vascular endothelial growth factor （VEGF） and platelet-reactive protein （TSP） in renal interstitial fibrosis and its correlation with CD3,, CD40. Methods Ninety-six pa- tients with different types of kidney selected in our hospital from May 2011 to May 2013 were enrolled in the study. All the patients were divided into mild injury group （n=38）, moderate injury group （n=32） and severe injury group （n=26）, according to the degree of kidney damage. Thirty healthy individuals were selected as the control group. The expression levels of VEGF, TSP, CD~, CD40 of each group were tested with immunohistochemical staining. Results VEGF was mainly expressed in podocytes plasma and renal tubular epithelial cells, and TSP was mainly expressed in the cyto- plasm of renal tubular epithelial cells, without expression in normal tissue cells. CD3, and CD4o were mainly expressed in the peritubular capillary endothelial cells. As the patient＇s condition increased, the positive expression of TSP, CD~ was significantly increased, while that of VEGF, CD3, was significantly reduced （P〈0.05）. According to univariate analysis, TSP, CD,o, respectively, was positively correlated with renal interstitial fibrosis, and VEGF, CD~ was nega- tively correlated with renal interstitial fibrosis. Conclusion Enhanced TSP expression in the kidney area and tubular epithelial cells, as well as reduced VEGF expression in podocytes and tubular epithelial cells may be the important fac- tor that causes the development of renal interstitial fibrosis.