内蒙地区IgA肾病患者血清IgA1分子N-乙酰半乳糖胺异常与其病理表现关系探讨

目的探讨内蒙地区蒙古族与汉族人群IgA肾病患者血清IgA1分子N-乙酰半乳糖胺异常程度与肾脏病理表现的关系。方法将入选的60例IgA肾病患者,用ELISA法测定蚕豆凝集素（VVL）与IgA1分子铰链区上N-乙酰半乳糖胺（GalNAc）的总结合力,即VVL总结合力,同时计算VVL与IgA1的结合力。将20例原发性肾病综合征微小病变与膜性肾病患者设为对照组,根据IgA1与VVL结合力的均值加减2个标准差为界,将IgA肾病组分为正常糖基化与低糖基化,同时进行常规肾活检。结果IgA1肾病组VVL总结合力、VVL与IgA1结合力情况与对照组比较有显著性差异（P〈0.05）;蒙古族与汉族IgA1糖基化程度、肾脏病理情况、年龄及血肌酐比较,无显著性差异（P〉0.05）。结论内蒙地区蒙古族与汉族人群中IgA1低糖基化程度与肾脏病理轻重无明显的相关关系,IgA肾病患者血清IgA1糖基化异常,血清低糖基化程度重者发病年龄较轻但肾小球滤过功能损伤较重。IgA1低糖基化程度尚不能推测肾脏病理轻重,并且在蒙古族与汉族人群中,低糖基化IgA1对IgA肾病的致病作用亦无差别。

Discussion of the Relationship between Serum IgA1 Molecular N-Acetlygalactosamine Abnormality and its Pathological Manifestations in IgA Nephropathy in Inner Mongolia Region

Objective To investigate the relationship between serum IgA1 molecular N - aeetylgalactosamine abnormality and pathological manifestations of nephropathy among Mongolian ethnicity and Hart group in Inner Mongolia region. Methods In 60 cases of nephropathy enrolled, ELISA method was used to determine the total cohesion between vicia villosa lectin（VVL） and N - acetylgalactosamine in IgA1 molecular hinge region （GalNAc）, meaning VVL total cohesion. Simultaneously, the cohesion between VVL and IgA1 was calculated. 20 cases of minimal change disease（MCD） and membranous nephropathy（MN） of primary nephritic syndrome were set up as control group. In light of mean cohesion of IgA1 and VVL with 2 standard deviations modified, IgA nephropathy group was divided into normal glycosylation and low glycosylation. Additionally, routine renal biopsy was conducted. Results Significant differences were presented in VVL total cohesion and cohesion between VVL and IgA1 in comparison between IgA nephropathy group and control group （P 〈 0.05 ）. There were no significant differences in IgA1 glycosylation, renal pathological situation, age and creatinine between Mongolian ethnicity and Han group in Inner Mongolia region （ P 〉 0.05 ）. Conclusion There is no apparent relevance between low glycosylation of IgA and renal pathological severity among Mongolian ethnicity and Han group in Inner Mongolia region. For IgA nephropathy, serum IgA1 glycosylation is abnormal and the serious serum low glycosylation occurs in quite young age, but glomerular filtration is damaged rather seriously. IgA1 of low glyeosylation cannot be used to deduce the severity of renal pathological condition. Additionally,among Mongolian ethnicity and Han group, there is no difference in the relationship between IgA1 of low glycosylation and nephropathy.