天津医药

天津医药 ›› 2021, Vol. 49 ›› Issue (9): 958-962.doi: 10.11958/20210080

• 临床研究 • 上一篇    下一篇

原发性肾病综合征患者肾组织中Angptl4与足细胞损伤及蛋白尿的相关性研究

彭雷，林英英，汪伟，姚琪，李贵森，张萍△   

  1. 电子科技大学附属医院•四川省人民医院肾脏内科（邮编610000）
  • 收稿日期:2021-01-14 修回日期:2021-05-31 出版日期:2021-09-15 发布日期:2021-09-18
  • 通讯作者: 张萍 E-mail:zhangping415@126.com
  • 基金资助:
    四川省科技厅应用基础项目（2021YJ0144）；四川省卫生和计划生育委员会普及应用项目（18PJ364）

Angptl4 is associated with podocyte injury and proteinuria in patients with primary nephrotic syndrome#br#

PENG Lei, LIN Ying-ying, WANG Wei, YAO Qi, LI Gui-sen, ZHANG Ping△   

  1. Department of Nephrology, Sichuan Provincial People's Hospital, University of Electronic Science and 
    Technology of China, Chengdu 610000, China
  • Received:2021-01-14 Revised:2021-05-31 Published:2021-09-15 Online:2021-09-18

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摘要： 摘要：目的　探讨原发性肾病综合征患者肾组织中血管生成素样蛋白4（Angptl4）与足细胞损伤及蛋白尿的关系。方法　选取原发性肾病综合征患者包括微小病变型肾病（MCD）组11例、膜性肾病（MN）组11例、系膜增生性肾小球肾炎（MsPGN）组9例，收集患者肾组织进行Angptl4及足细胞损伤标志物desmin免疫荧光染色，计算荧光强度。将Angptl4分别与足细胞标志物synaptopodin、系膜细胞标志物CD90、内皮细胞标志物CD31及基底膜标志物laminin进行双染以观察Angptl4与各类细胞的重合度。收集患者性别、年龄、24 h尿蛋白定量、血脂及血清肌酐等资料，对Angptl4表达与desmin免疫荧光染色定量、24 h蛋白尿定量、血脂分别进行相关性分析。结果　各组性别、年龄、血清肌酐及24 h尿蛋白定量差异无统计学意义。与MsPGN组相比，MCD及MN组肾小球Angptl4表达增加（P＜0.05），增加的Angptl4与足细胞重合度最高。肾小球中Angptl4表达与desmin表达及24 h尿蛋白定量相关（P＜0.01），与血清三酰甘油及血清总胆固醇不相关（P＞0.05）。结论　在原发性MCD及MN患者中，肾小球Angptl4表达增加且与足细胞损伤和蛋白尿相关，与血脂不相关。

关键词: 血管生成蛋白质类；肾病综合征；肾病, 脂性；肾小球肾炎, 膜性；足细胞；蛋白尿；血管生成素样蛋白4

Abstract: Abstract: Objective　To study the relationship between angiopoietin-like 4 (Angptl4) and podocyte injury and protein uria in renal tissues of patients with primary nephrotic syndrome. Methods　Patients with primary nephrotic syndrome, including 11 cases of minimal change disease (MCD), 11 cases of membranous nephropathy (MN) and 9 cases of mesangial proliferative glomerulonephritis (MsPGN) were enrolled in this study. Renal tissues were collected during biopsy for Angptl4 and podocyte injury marker desmin immunofluorescence stainning, and fluorescence intensity was calculated. Angptl4 was double stained with podocyte marker synaptopodin, mesangial cell marker CD90, endothelial cell marker CD31 and glomerular basement membrane marker laminin to study the overlap rate of Angptl4 with various types of cells. The basic information of gender, age, 24 h-urine protein, serum triglycerides, serum total cholesterol and serum creatinine were collected. The correlation between the expression of Angptl4 and desmin immunofluorescence intensity, 24 h protein uria, serum triglycerides and serum total cholesterol was analyzed. Results　There were no significant differences in gender, age, serum creatinine and 24 h-urine protein between the three groups (P＞0.05). Compared with MsPGN patients, the glomerular Angptl4 expression increased in MCD and MN patients (P＜0.05), and the increased Angptl4 had the highest degree of overlap with podocytes rather than mesangial cells, endothelial cells or endothelial cells. Angptl4 expression in glomeruli was correlated with glomerular desmin expression and 24 h-urine protein (P＜0.01), but not correlated with the serum triglycerides and serum total cholesterol (P＞0.05). Conclusion　In patients with primary MCD and MN, the expression of glomerular Angptl4 is increased, which is associated with podocyte injury and proteinuria, but not with blood lipids.

Key words: angiogenic proteins, nephrotic syndrome, nephrosis, lipoid, glomerulonephritis, membranous, podocytes, proteinuria, angiopoietin-like 4