摘要
目的探讨肺炎衣原体(CP)感染与IgA肾病(IgAN)的相关性。方法选取70例原发性IgAN病例为研究对象,同时以70例健康献血员血清和12例意外死亡者的尸检肾组织为对照。应用间接免疫荧光法检测血清CP IgG和CP IgA抗体滴度;应用荧光定量PCR检测肾组织CP DNA。分析CP感染和肾组织CP DNA阳性与IgAN临床表现和肾组织病理改变的关系。结果 IgAN组CP持续感染率高于健康献血组,差异有统计学意义(P<0.01)。IgAN组内不同临床类型的CP急性感染、既往感染、未感染构成比无显著性差异(P>0.05)。大量蛋白尿者、持续性肾功能不全的CP持续感染高于非大量蛋白尿者(P<0.05)。CP持续性感染患者肾小球病理评分、肾小管间质评分高于非持续性感染患者(P<0.05)。CP持续性感染患者肾脏病理病变较非持续性感染患者明显而严重。大量蛋白尿者和持续性肾功能不全型的CP DNA阳性率高于临床类型表现为非大量蛋白尿者(P>0.05)。肾组织CP DNA阳性患者肾小球病理评分(P<0.05)、肾小管间质病理评分(P<0.01)高于阴性患者。肾组织CP DNA阳性患者病理病变较阴性患者明显而严重。CP持续性感染和肾组织CP DNA阳性相关(P<0.01)。结论IgAN发病与CP持续感染相关,而与CP既往感染、急性感染不明显。
Objective To explore the correlations between Chlamydia pneumoniae （CP） infection and IgA nephropathy （IgAN）. Methods Seventy patients with primary IgAN were enrolled in the study. Seventy serum specimens from healthy blood donors and twelve renal autopsy specimens from accidental death bodies were regarded as control groups. Serum CP IgG and CP IgA antibody titers were detected by indirect immunofluorescence. CP DNA of renal tissue was measured by fluorescent quantitative PCR. Finally, using statistical methods, we analyzed the correlations of CP infection and CP DNA of renal tissue with clinical manifestations and kidney pathological changes of IgAN patients. Results The rate of CP persistent infection in IgAN group was higher than that of healthy blood donor group （ P 〈 0.01 ）. The rate was not significantly different within the IgAN group, such as among acute infection, previous infection and no infection subgroups （ P 〉 0.05）. It was higher in the patients with gross proteinuria and/or durative renal insufficiency than in non-gross proteinuria patients （ P 〈 0.05）. The scores of glomerular patholopical and tubulointerstitial injury of CP persistent infection patients were higher than those of non-persistent infection ones （ P 〈 0.05）. The renal injury of CP persistent infection patients was more severe than that of non-persistent infection ones. The positive rate of CP DNA in gross proteinuria and/or renal insufficiency patients was higher than that of non-gross proteinuria patients （ P 〈 0.05）. The scores of glomerular pathological and tubulointerstitial injury of positive CP DNA patients were respectively higher than those of negative CP DNA ones （P 〈 0.05, P 〈 0.01 ）. The renal injury of patients with positive CP DNA was more severe than that of negative CP DNA ones. CP persistent infection was obviously correlated with renal CP DNA （ P 〈 0.01 ）. Conclusion Primary IgAN is associated with CP persistent infection, but not with CP previous infection or CP acute infection.
出处
《细胞与分子免疫学杂志》
CAS
CSCD
北大核心
2014年第7期754-758,共5页
Chinese Journal of Cellular and Molecular Immunology
基金
河南省教育厅自然科学基金(2006320040)
关键词
IGA
肾小球
肺炎衣原体
感染
蛋白尿
IgA nephropathy
glomerulus
Chlamydia pneumoniae
infection
proteinuria
