Pax2、增殖细胞核抗原、细胞凋亡在肾病综合征激素耐药中的作用

目的观察原发性肾病综合征（PNS）激素敏感与激素耐药组患儿Pax2、增殖细胞核抗原（PCNA）表达及细胞有效凋亡率，探讨Pax2在肾脏檐皮质激素（GC）耐药中的作用。方法采用免疫组织化学法观察PNS患儿40例肾活检组织Pax2、PCNA表达，采用荧光显微镜检测细胞凋亡。结果激素敏感组Pax2适量表达，与PCNA阳性表达呈正相关,激素耐药组，Pax2呈过度表达，与PCNA阳性表达无明显相关性。Pax2始终与细胞凋亡旱负相关。结论Pax2适量表达，通过促进细胞增殖及抑制凋亡，修复受损的小管-间质。Pax2过度表达，细胞增殖与凋亡进一步减少，导致肾小管病理改变加重，使其对激素不敏感共至耐药。

Effects of Paired Box2, Proliferation Cell Nuclear Antigen and Cell Apoptosis in Nephrotic Syndrome with Steroid - Resistance

Objective To investigate the expression of paired box2(Pax2),proliferation cell nuclear antigen(PCNA) and cell apoptosis in steroid-sensitive and steroid-resistant groups with primary nephrotic syndrome(PNS) and to find out the action of Pax2 expression in PNS with steroid-resistance.Method The expressions of Pax2,PCNA were evaluated by immunohistochemistry and cell apoptosis by fluorescence micoscope.Results Pax2 expression in renal tubule had a positive correlation with PCNA expression in steroid-sensitive group.In steroid-resistant group,Pax2 expression had no correlation with PCNA.Pax2 had a negative correlation with cell apoptosis.Conclusions Pax2 proper expression facilitate PCNA expression and repair tubulointerstitial lesions in steroid-sensitive group.Renal tubular epithelial cell proliferation coordinated with cell apoptosis.Pax2 overexpression in steroid-resistant group lead to the decrease of cell proliferation and cell apoptosis and lead to the severe tubule lesions,which made to glucocorticoid resistance.