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[目的]通过检测不同程度肾间质纤维化的IgA肾病患者肾血液及尿液中的PDGF-BB,并结合肾脏病理改变及肾组织PDGF-BB的表达作相关性分析;探讨血、尿PDGF-BB测定与肾间质纤维化的关系,寻找方便临床检测的监测肾间质纤维化的有效指标。[方法]通过肾活检收集40例IgA肾病患者的肾组织病理标本及其相对应的血、尿标本。采用酶联免疫吸附法检测各观察组相对应患者的血清和尿液的PDGF-BB等指标,采用SABC法检测肾组织PDGF-BB、PDGFR-β的表达,并计算各观测指标的平均光密度。实验数据采用SPSS16.0统计分析软件进行计算分析得出结论。两组间比较使用H检验。各观测指标间作spearman秩相关性分析。P﹤0.05为差异有统计学意义。[结果]①肾组织中PDGF-BB及PDGFR-β的表达强度随着肾间质纤维化严重程度的增加而增高,在肾间质纤维化肾组织中PDGF-BB及PDGFR-β的表达明显高于对照组(P﹤0.01)。②对照组血PDGF-BB的浓度是(182.25±24.90)pg/ml,实验组血PDGF-BB的水平分别是(271.51±27.38)pg/ml、(330.34±35.27)pg/ml、(499.52±73.00)pg/ml,实验组各组的患者血清PDGF-BB水平显著高于对照组(P﹤0.05);实验组中随着肾间质纤维化程度加重而表现患者血清PDGF-BB水平增高,两者关系呈正相关。③对照组患者尿PDGF-BB的浓度是(1924.2±577.30)pg/ml。实验组尿PDGF-BB的水平分别是是(3643.2±865.99)pg/ml,(5301.0±462.03)pg/ml,(7157.0±1433.99)pg/ml。实验组各组的患者尿液PDGF-BB水平显著高于对照组(P﹤0.05);实验组中随着肾间质纤维化程度加重而表现患者尿液PDGF-BB水平增高,两者关系呈正相关。④所观察病例的肾组织PDGF-BB表达与血PDGF-BB水平呈正相关,与尿PDGF-BB水平呈正相关。肾组织PDGFR-β表达与血PDGF-BB水平呈正相关,与尿PDGF-BB水平呈正相关。[结论]在肾纤维化肾组织中,PDGF-BB、PDGFR-β在肾小管表达显著增加,并随着纤维化程度加重而表达增加,提示PDGF-BB是肾小管间质纤维化的重要致病因子。肾组织PDGF-BB和PDGFR-β的表达与血、尿PDGF-BB水平正相关,提示血、尿PDGF-BB变化可反映肾间质纤维化的严重程度,血、尿PDGF-BB测定可作为临床监测肾间质纤维化的指标。
[Objective] To investigate the relationship between PDGF-BB in renal blood and urine of IgA nephropathy patients with different degrees of renal interstitial fibrosis and pathological changes of kidney and the expression of PDGF-BB in kidney. -BB determination and renal interstitial fibrosis relationship, looking for the convenience of clinical detection of renal interstitial fibrosis to monitor effective indicators. [Method] The renal biopsy specimens of 40 patients with IgA nephropathy and their corresponding blood and urine samples were collected. The serum and urine PDGF-BB and other indexes in each observation group were detected by enzyme-linked immunosorbent assay. The expressions of PDGF-BB and PDGFR-β in renal tissue were measured by SABC method. The average optical density of each observation index . Experimental data using SPSS16.0 statistical analysis software to calculate the conclusion. H-test was used to compare the two groups. Spearman rank correlation analysis between the observed indicators. P <0.05 for the difference was statistically significant. [Results] ① The expression of PDGF-BB and PDGFR-β in renal tissue increased with the severity of renal interstitial fibrosis, and the expression of PDGF-BB and PDGFR-β in renal interstitial fibrosis was significant Higher than the control group (P <0.01). ② The level of PDGF-BB in the control group was (182.25 ± 24.90) pg / ml and the levels of PDGF-BB in the experimental group were (271.51 ± 27.38) pg / ml, (330.34 ± 35.27) pg / ml, 73.00) pg / ml, PDGF-BB level in the experimental group was significantly higher than that in the control group (P <0.05). The level of PDGF-BB in the experimental group was increased with the severity of renal interstitial fibrosis, The relationship between the two was positively correlated. ③ The urinary PDGF-BB concentration in the control group was (1924.2 ± 577.30) pg / ml. The levels of urinary PDGF-BB in the experimental group were (3643.2 ± 865.99) pg / ml, (5301.0 ± 462.03) pg / ml and (7157.0 ± 1433.99) pg / ml, respectively. The level of PDGF-BB in the urine of patients in each experimental group was significantly higher than that in the control group (P <0.05). The level of PDGF-BB in the urine of the experimental group increased as the degree of renal interstitial fibrosis increased, Related. ④ The expression of PDGF-BB in renal tissue was positively correlated with the level of PDGF-BB in blood and positively correlated with the level of PDGF-BB in urine. The expression of PDGFR-β in renal tissue was positively correlated with the level of PDGF-BB in blood and positively correlated with the level of PDGF-BB in urine. [Conclusion] The expressions of PDGF-BB and PDGFR-β in renal tubules were significantly increased in renal fibrosis renal tissues and increased with the degree of fibrosis, suggesting that PDGF-BB is important in tubulointerstitial fibrosis Etiological factor. The expression of PDGF-BB and PDGFR-β in renal tissue positively correlated with the level of PDGF-BB in blood and urine, suggesting that the changes of PDGF-BB in blood and urine may reflect the severity of renal interstitial fibrosis. Clinical indicators of renal interstitial fibrosis.