论文部分内容阅读
目的探讨血小板反应蛋白-1(Thrombospondin-1,TSP-1)在人类系膜增生性肾小球肾炎(MsPGN)中的蛋白表达及其在发病中的作用。方法采用HE、PAS、PASM及免疫组织化学SABC染色法对56例系膜增生性肾小球肾炎(mesangial proliferative glomerulonephritis,MsPGN)肾活检组织进行观察,并经计算机医学图像分析系统进行分析。结果参照1982年WHO关于肾小球病理学分类标准,分为轻、中、重度三组,重度系膜组织增生组24h尿蛋白定量、白蛋白、甘油三酯、总胆固醇均较轻、中度系膜组织增生组明显升高(P均<0.05);三组内生肌酐清除率无明显差别;有肾间质病变内生肌酐清除率(CCr)为(91.13±42.52)ml/min,无肾间质病变CCr为(122.82±36.59)ml/min差异有统计学意义(P<0.05),24h尿蛋白定量、尿α-1微球蛋白差异也有统计学意义(P<0.05)。在各组MsPGN切片中TSP-1均有阳性表达,阳性反应主要分布在肾小球系膜区、部分毛细血管襻及肾小管上皮细胞胞浆,随增生程度明显增加(P<0.05)。在无明显病变的肾间质中未见TSP-1表达,随着病变程度加重,TSP-1的表达量显著增加,在炎症浸润及纤维化显著的间质区亦可见表达增强(P<0.01)。光镜观察是否存在肾小球袢内微血栓,MsPGN伴肾小球毛细血管袢内微血栓(MsPGN+T)组TSP-1蛋白表达明显增强(P<0.05)。结论 MsPGN时病理改变和临床指标24h尿蛋白定量、白蛋白、甘油三酯、总胆固醇、CCr有一定关系,TSP-1蛋白在肾小球与肾小管表达均显著增高,病理改变有血栓时则更明显,提示该因子在MsPGN发病中有一定的作用。
Objective To investigate the protein expression of Thrombospondin-1 (TSP-1) in human mesangial proliferative glomerulonephritis (MsPGN) and its role in the pathogenesis. Methods 56 cases of mesangial proliferative glomerulonephritis (MSPGN) renal biopsy were observed by HE, PAS, PASM and immunohistochemical SABC staining and analyzed by computer medical image analysis system. The results with reference to the 1982 WHO classification of glomerular pathology, divided into mild, moderate and severe three groups, severe mesangial tissue hyperplasia 24h urinary protein, albumin, triglycerides, total cholesterol were mild, moderate (P <0.05). There was no significant difference in endogenous creatinine clearance among the three groups. The CCr of renal interstitial lesions was (91.13 ± 42.52) ml / min, with no significant difference The CCr of renal interstitial lesions was (122.82 ± 36.59) ml / min, with statistical significance (P <0.05). The urinary protein excretion and urinary α-1 microglobulin also had statistical significance (P <0.05). The positive expression of TSP-1 in each group of MsPGN sections was mainly observed in the glomerular mesangial area, part of the capillaries and the cytoplasm of renal tubular epithelial cells, with a significant increase (P <0.05). TSP-1 expression was not found in the renal interstitium without obvious pathological changes. The expression of TSP-1 was significantly increased with the severity of the lesion, and also enhanced in the interstitial infiltration and fibrosis (P <0.01) ). The presence of microthrombi in glomerulus was observed with light microscopy. The expression of TSP-1 protein in MsPGN with MsPGN + T group was significantly increased (P <0.05). Conclusion The pathological changes of MsPGN and clinical indicators of 24h urinary protein, albumin, triglycerides, total cholesterol, CCr have a certain relationship, TSP-1 protein expression in glomeruli and tubules were significantly increased pathological changes were thrombosis More obvious, suggesting that the factor in the pathogenesis of MsPGN have a role.