摘要
目的探讨原发肾病综合征（NS）患者肾小球足细胞中裂孔隔膜蛋白nephrin、Wilm肿瘤蛋白1（WTl）的表达及分布特征。方法选择肾病综合患者80例（NS组），根据其病理诊断水平分为微小病变（MCN）组、IgA肾病组、膜性肾病（MN）组、局灶节段性肾小球硬化（FSGS）组，每组20例；另设正常对照组10名。采用免疫组织化学方法检测各组肾小球nephrin、WT1的表达指数（EI），并进行组间比较。结果①正常对照组nephrin在肾小球毛细血管壁，呈均匀、线状分布；肾病综合征组患者nephrin在肾小球中分布不均，部分区域染色明显减弱，部分区域线性消失，呈颗粒状或者团块状。MN组和IgA肾病组与正常对照组比较显著降低（P〈0．05）。nephrin的表达水平与24h尿蛋白定量呈负相关（r=-0．216，P〈0．05），与白蛋白呈正相关（r=0．300，P〈O．01）。②WT1在肾小球足细胞胞核内表达。MCN组、IgA肾病组及FSGS组与正常对照组比较表达下降（P〈0．05）。WT1的表达与24h尿蛋白定量呈负相关（r=-0．304，P〈0．05），与血浆白蛋白呈正相关（r=0．338，P〈0．01）。结论NS早期即可出现肾小球足细胞中nephrin、WT1的表达和分布减少，而且随着病变的加重，这种变化愈发明显。足细胞病不仅导致大量蛋白尿发生，而且还可能与肾小球硬化的发生有关。
Objective To investigate the expression and distribution of nephrin and WT1 in the development of proteinuria in patients with primary nephrotic syndrome. Methods A total of 90 renal biopsies were enrolled in this study, including 80 from the patients with primary nephrotic syndrome, and 10 from nephrectomy kidneys as control group. Immunohistochemistry was applied to detect the expression index （EI） for nephrin and WT1 in renal glomerulus of nephrotic syndrome group and control group. Results （I）In nephrotic syndrome group, the distribution of nephrin showed granular pattern. Staining in some regions was apparently decreased and the linear pattern disappeared in some regions. The expression of nephrin in MN group and IgA groupwas decreased greatly as compared with that in control group （P〈0. 05） ; （2）WT1 was expressed in the podocyte nucleus and cytoplasm. The expression of WT1 in MCN group, IgA group and FSGS group was decreased as compared with that in control group （3.51 ± 0. 51） （P〈0. 05） ; （3）The expression of WT1 and nephrin was negatively correlated with 24 h urine protein quantitation, but positively with plasma Alb. Conclusions The injury of podoeyte was observed, and the expression of nephrin and WT1 was decreased significantly in patients with nephrotic syndrome; The injury of podocyte was negatively with urine protein, but positively with glomerulosclerosis.
出处
《临床肾脏病杂志》
2010年第7期311-313,F0002,共4页
Journal Of Clinical Nephrology
关键词
肾病综合征
足细胞
蛋白尿
Nephrotic syndrome
Podocyte
Proteinuria
