尿足细胞阳性IgA肾病患者临床病理特点

目的探讨尿足细胞阳性原发性IgA肾病（IgAN）患者临床病理特点。方法50例肾活检明确诊断的IgAN患者和10例健康志愿者，利用足细胞的标记蛋白Podocalyxin（PCX）标记尿液和肾组织足细胞，采集IgAN患者肾活检时临床资料、肾活检光镜结果，其中光镜参照Hass分级，各项病理指标参照Fofi半定量积分法进行评分，荧光显微镜观察肾组织足细胞PCX荧光表达程度，电镜观察足细胞足突形态学改变。结果①尿足细胞阳性的IgAN患者尿蛋白水平、血肌酐水平、平均动脉压较尿足细胞阴性患者增高，血浆白蛋白、肾小球滤过率（GFR）较尿足细胞阴性患者降低（P〈0．05）；②光镜示尿足细胞阳性的IgAN患者肾小球硬化程度、新月体发生率较尿足细胞阴性患者增高（P〈0．05），而两组比较，系膜增生、基质增多、肾小管萎缩、间质纤维化、间质炎细胞浸润、间质血管硬化程度的差异无统计学意义（P〉0．05）；③肾组织足细胞PCX抗体荧光表达显示：肾小球节段硬化和球性硬化处足细胞PCX抗体荧光表达缺失；④电镜观察提示，无论是否伴足细胞尿，其足细胞足突均可出现一系列形态学改变。结论足细胞尿是反映肾脏疾病轻重的一个指标，与肾脏病理类型有一定关系。

Clinicopathological features of the primary IgA nephropathy patients with positive urinary podocyte

Objective To analyze the clinical and pathological features of the primary IgA nephropathy(IgAN) patients with positive urinary podocyte. MethodsFifty patients,who were clearly diagnosed as primary IgA nephropathy by renal biopsy,and 10 healthy volunteers were enrolled in this study.Podocalyxin(PCX),specific expressed by podocyte cells as a marker protein,was used to mark the podocyte cells collected from patients urine and kidney tissues.Clinical data were documented when the renal biopsy carried out.The ...