IgA肾病患者肾脏MCP-1的表达及意义

目的观察Ig A肾病患者肾脏单核细胞趋化蛋白-1（MCP-1）表达变化,并探讨其作用。方法用免疫组织化学染色法检测34例同步行肾活检诊断明确的Ig A肾病患者肾脏MCP-1表达,用肌氨酸氧化酶法检测血清肌酐（Scr）,比较不同程度肾小管间质病变及不同血清肌酐水平患者MCP-1的差异。用SDS-PAGE法检测尿蛋白分子量,并进一步分型,对不同分子量尿蛋白患者的MCP-1水平进行比较。采用Pearson相关分析Ig A肾病患者的MCP-1及24 h尿蛋白的相关性。结果 Ig A肾病患者肾组织MCP-1主要表达在肾小管上皮细胞内,与24 h尿蛋白定量呈正相关（r=0.34,P〈0.05）。肾小管间质病变分级重度组肾组织MCP-1表达较轻度组升高（P〈0.05）,Scr〉140μmol/L的Ig A肾病患者较Scr≤140μmol/L者升高（P均〈0.05）,混合性尿蛋白10 k D的Ig A肾病患者较23 k D者升高（P〈0.05）。结论肾组织MCP-1表达增加在Ig A肾病患者肾小管间质病变及肾功能损害中起重要作用。尿蛋白为10 k D的Ig A肾病患者肾组织MCP-1表达增加明显。

Expression of monocyte chemoattractant protein-1 in IgA nephropathy and its significance

Objective To evaluate the role of monocyte chemoattractant protein-1（MCP-1） in the mechanism of progression of Ig A nephropathy.Methods A total of 34 patients with biopsy proven Ig A nephropathy were studied.The expression of MCP-1 in renal tissues were detected by immunohistochemical staining method; the levels of serum creatinine（Scr） were examined by sarcosine oxidase method; MCP-1 expression in renal tissue in patients with different degree of tubulointerstitial lesions and different levels of Scr were compared.Molecular weight of urinary protein were detected by sodium dodecyl sulfate-polyacrylamide gel electrophoresis（SDS-PAGE）,and were further typed; MCP-1 expression in renal tissue in patients with different molecular weight of urinary protein were compared.And the relationship between the MCP-1expression and the twenty-four-hour urine protein quantitation in patients with Ig A nephropathy was analyzed by pearson correlation analysis.Results MCP-1 expression was mainly in renal tubular epithelial cells of Ig A nephropathy patients,and was in positive correlation to twenty-four-hour urine protein quantitation（r = 0.34,P〈0.05）.MCP-1 expression was significantly higher in grade severe group than in grade mild group of Ig A nephropathy patients according to classification of tubulointerstitial lesions（P〈0.05）,was significantly higher in Scr 140 μmol / L group than Scr≤140 μmol / L group（P〈0.05）,and was significantly higher in 10 k D proteinuria group than 23 k D proteinuria group（P〈0.05）.Conclusion MCP-1 may play an important role in the progression of Ig A nephropathy.Low molecular weight urinary protein such as 10 k D protein may have close relationship with the expression of MCP-1 in renal tissue of Ig A nephropathy.