论文部分内容阅读
目的探讨急性肾损伤(AKI)患儿肾脏局部促红细胞生成素(EPO)、EPO受体的表达与肾脏病理损害的关系。方法 2005年1月-2009年12月在本院住院并行肾活检的38例AKI患儿(男29例,女9例)。年龄中位数为4.04岁(2个月～11岁9个月),病程中位数为6.89 d(1～30 d)。将AKI 1期及AKI 2期患儿归为轻症病例组,AKI 3期患儿归为重症病例组,对照组为同期住院并经肾活检诊断为薄基膜肾病的患儿。采用免疫组织化学方法检测所有患儿肾组织EPO及EPO受体的表达,应用肾脏病理计量评分法对肾小管间质损害进行半定量分析,分析肾小管间质损害程度与肾组织EPO及EPO受体表达之间的关系。结果 1.AKI患儿38例中轻症病例组8例均痊愈,重症病例组28例痊愈,2例预后差。肾脏病理以肾小管间质损害为主。轻症病例组、重症病例组肾小管间质病理损害计分为(10.56±3.40)分、(15.56±4.70)分,组间比较差异有统计学意义(t=-2.832,P<0.01)。2.对照组、轻症病例组、重症病例组EPO的阳性表达面积分别为(6.52±2.12)%、(3.02±0.79)%、(1.62±0.18)%,组间比较差异有统计学意义(P<0.01);3组EPO受体的阳性表达面积分别为(40.46±8.42)%、(64.78±16.38)%、(62.36±15.67)%,组间比较差异亦有统计学意义(P<0.01)。3.肾小管间质的病理损害与EPO在肾小管间质的阳性表达面积呈负相关(r=-0.872,P<0.01),而与EPO受体在肾小管间质的阳性表达面积呈正相关(r=0.772,P<0.01)。结论 AKI患儿肾脏局部EPO的分泌受抑制,而EPO受体表达增高,提示应用外源性EPO可能有助于肾脏修复。
Objective To investigate the relationship between renal erythropoietin (EPO) and EPO receptor expression and renal pathological damage in children with acute kidney injury (AKI). Methods From January 2005 to December 2009, 38 children with AKI who underwent renal biopsy (29 males and 9 females) were hospitalized in our hospital. The median age was 4.04 years (ranged from 2 months to 11 years and 9 months), with a median duration of 6.89 days (ranged from 1 to 30 days). Patients with AKI stage 1 and AKI stage 2 were classified as mild cases, AKI stage 3 cases were classified as severe cases and controls as patients with thin basement membrane nephropathy who were hospitalized in the same period and who had renal biopsy. Immunohistochemistry was used to detect the expression of EPO and EPO receptors in renal tissue of all children. Semi-quantitative analysis of tubulointerstitial lesions was performed by using renal pathological grading method. The levels of tubulointerstitial lesions and the levels of EPO and EPO The relationship between body expression. Results 1. In 38 cases of AKI children, 8 cases of mild cases were cured, 28 cases of severe cases cured, 2 cases of poor prognosis. Renal pathology mainly tubulointerstitial damage. The scores of tubulointerstitial lesions in mild and severe cases were (10.56 ± 3.40) and (15.56 ± 4.70), respectively. The difference between the two groups was statistically significant (t = -2.832, P <0.01). The positive expression area of EPO in control group, mild case group and severe case group were (6.52 ± 2.12)%, (3.02 ± 0.79)% and (1.62 ± 0.18)%, respectively. There was significant difference between the two groups (P <0.01). The positive expression area of EPO receptor in the three groups were (40.46 ± 8.42)%, (64.78 ± 16.38)%, (62.36 ± 15.67)%, respectively ). Tubulointerstitial pathological damage and EPO in the tubulointerstitial positive expression area was negatively correlated (r = -0.872, P <0.01), but with the EPO receptor in tubulointerstitial positive expression area was positively correlated (r = 0.772, P <0.01). Conclusions The secretion of EPO in the kidneys of AKI children is inhibited, while the expression of EPO receptor is increased. It suggests that exogenous EPO may be helpful for renal repair.