天津医药

• 论著 •    

乙酰肝素酶在原发性IgA肾病患者肾小球中表达的差异及意义

曹英杰,陈晓岚,范亚平,杨红利   

  1. 南通大学附属医院肾内科
  • 收稿日期:2011-12-20 修回日期:2012-07-24 出版日期:2012-12-15 发布日期:2012-12-15
  • 通讯作者: 曹英杰

Clinical Significance of the Difference Expressions of Heparanase in Glomerulus of IgA Nephropathy

  • Received:2011-12-20 Revised:2012-07-24 Published:2012-12-15 Online:2012-12-15

摘要： 目的：探讨IgA肾病患者肾小球中乙酰肝素酶（Hpa）表达的差异及其与临床相关指标的关系。方法：选择本院自2000年以来肾穿刺为IgA肾病的患者78例，按照Lee氏Ⅰ~Ⅳ级分为4组，比较各组患者的临床指标包括尿素氮、血清肌酐、24 h尿蛋白定量及尿C3、尿变形红细胞等，免疫组化法检测肾组织中Hpa的表达；对照组采用肾癌患者肾切除标本中无癌细胞浸润的正常肾组织。结果：对照组肾小球内仅有极少量Hpa表达，4组IgA肾病患者肾小球内均有Hpa表达，与对照组相比差异有统计学意义（P<0.05），IgA肾病4组间肾小球内Hpa表达强度差异亦有统计学意义（P<0.01）。且其表达的强度与24 h尿蛋白定量呈正相关（P<0.01），与血肌酐、尿素氮、尿沉渣红细胞计数及尿C3水平无明显相关性（P>0.05）。结论：Hpa的异常表达参与IgA肾病的病理损害与蛋白尿的形成，下调Hpa有益于IgA肾病的转归。

关键词: 肾小球肾炎, IGA, 肾小球, 蛋白尿, 免疫组织化学, 乙酰肝素酶

Abstract: Objective:To explore the expression of heparanase in glomerulus of patients with IgA nephropathy and its relationship with clinical parameters. Methods:A total of 78 patients with IgA nephropathy diagnosed by biopsy were classified into 4 groups according to the Lees classification. Comparing the clinical parameters in patients of five groups including urea nitrogen, serum creatinine, 24h proteinuria quantitation and complement in urine and hematuria. Immunohistochemistry was applied to detect the expression of Hpa in glomerulus of patients with IgAN and control group. Results:Heparanase expressed at a very low level in the glomerulus in control group.Compared with control group, the expressions of heparanase were significantly increased in glomerulus of IgAN groups (P<0.05). There was significant difference of the expressions of heparanase in 4 groups (P<0.01). The expressions of heparanase positively correlated with the 24h proteinuria quantitation (P<0.01); moreover the expressions of Hpa did not correlate with serum creatinine, urea nitrogen, complement in urine and hematuria (P>0.05). Conclusion:The abnormal expressions of heparanase may correlate with the renal pathology and the development of proteinuria in patients with IgAN ，namely, down- regulation of heparanase may be good for the recovery of IgAN.

Key words: glomerulonephritis, IgAkidney glomerulusproteinuriaimmunohistochemistryheparanase