本文選題：原發(fā)性腎病綜合征 + 高遷移率族蛋白-1��； 參考：《湖南師范大學(xué)》2014年碩士論文

【摘要】：研究背景：原發(fā)性腎病綜合征(primary nephritic syndrome)是一種常見的免疫炎癥性疾病,目前其發(fā)病機(jī)制尚不十分明確,大多數(shù)學(xué)者認(rèn)為,發(fā)病過程中起主導(dǎo)作用的還是免疫介導(dǎo)和炎癥損傷。多種炎癥因子及免疫反應(yīng)參與了腎病的發(fā)病機(jī)制,與疾病的進(jìn)展有著直接關(guān)系。高遷移率族蛋白-1(high mobility group box-1,HMGB-1)是一種較新型的炎癥細(xì)胞因子,其普遍存在于真核生物體內(nèi),可存在于細(xì)胞內(nèi)及細(xì)胞外。目前國(guó)內(nèi)外相關(guān)研究證實(shí),HMGB-1在慢性腎功能不全、狼瘡性腎炎、糖尿病腎病、急性腎功能損害、ANCA相關(guān)性血管炎腎損害、腎缺血再灌注損害等疾病中均呈高表達(dá)。在信號(hào)轉(zhuǎn)導(dǎo)機(jī)制的研究中證實(shí),HMGB-1可與其受體RAGE、Toll樣受體(Toll-like receptor,TLR2/TLR4)等相互作用,通過活化MAPK. MyD88等多種途徑最終活化NF-κB(nuclear factor-kappa B,NF-κB),引發(fā)炎癥反應(yīng)。既往已有研究證實(shí)NF-κB在腎病綜合征患者中呈高水平表達(dá),參與了原發(fā)性腎病綜合征的發(fā)生與發(fā)展過程。目前國(guó)內(nèi)外關(guān)于原發(fā)性腎病綜合征與炎癥因子HMGB-1的相關(guān)性研究及其在原發(fā)性腎病綜合征患者血清中的變化尚未見報(bào)道,分析其與NF-KB的相關(guān)性,進(jìn)一步探討其在原發(fā)性腎病綜合征發(fā)病中的作用。 目的：通過對(duì)原發(fā)性腎病綜合征患者外周血清中HMGB-1.NF-κB濃度的測(cè)定及兩者間相互關(guān)系的分析,探討HMGB-1在原發(fā)性腎病綜合征中的作用。 方法：收集我院2013年1月-2014年1月在湖南省人民醫(yī)院住院的初次診斷的原發(fā)性腎病綜合征患者46例為腎綜組(NS組),同期健康體檢者30例作為正常對(duì)照組(NC組)。收集兩組受試者性別、年齡、血清白蛋白(AIB)、膽固醇(Chol).甘油三脂(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、尿蛋白定量、C-反應(yīng)蛋白等相關(guān)臨床資料,同時(shí)采用酶聯(lián)免疫吸附法(ELISA法)檢測(cè)了外周血清中HMGB-1.NF-κB的濃度。變量之間相關(guān)性分析采用Pearson相關(guān)性分析及多元線性逐步回歸分析進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果： 1.NS組HMGB-1.NF-κB的濃度明顯高于NC組,差異有統(tǒng)計(jì)學(xué)意義(P0.01)。 2.Pearson相關(guān)分析提示：HMGB-1與尿蛋白定量、甘油三酯、總膽固醇、低密度脂蛋白、CRP呈正相關(guān),與白蛋白呈負(fù)相關(guān)。NF-KB與尿蛋白定量、甘油三酯、總膽固醇、低密度脂蛋白呈正相關(guān),與白蛋白呈負(fù)相關(guān)。多元線性回歸分析顯示：HMGB-1與尿蛋白定量獨(dú)立相關(guān),NF-κB與尿蛋白定量獨(dú)立相關(guān)。 3.相關(guān)分析結(jié)果顯示,HMGB-1與NF-κB之間呈正相關(guān),相關(guān)系數(shù)=0.793,P0.01,差異有統(tǒng)計(jì)學(xué)意義。 結(jié)論： 1.HMGB-1.NF-κB在原發(fā)性腎病綜合征血清中表達(dá)水平上調(diào),且兩者呈正相關(guān)。 2.HMGB-1可能通過影響NF-κB在原發(fā)性腎病綜合征的發(fā)病過程中發(fā)揮作用。 3.蛋白尿定量與原發(fā)性腎病綜合征中炎癥反應(yīng)密切相關(guān)。
[Abstract]:Background: primary nephritic syndrome (PNS) is a common immune inflammatory disease. At present, the pathogenesis of primary nephrotic syndrome (PNS) is not very clear. Most scholars believe that immune-mediated and inflammatory injury play a leading role in the pathogenesis of primary nephrotic syndrome. A variety of inflammatory factors and immune responses are involved in the pathogenesis of nephropathy, and have a direct relationship with the progression of the disease. High mobility group protein high mobility group box-1 (HMGB-1) is a new type of inflammatory cytokine. It is widely found in eukaryotes and can be found both in cells and outside cells. At present, HMGB-1 is highly expressed in chronic renal insufficiency, lupus nephritis, diabetic nephropathy, acute renal dysfunction associated vasculitis and renal ischemia-reperfusion injury. In the study of signal transduction mechanism, it has been proved that HMGB-1 can interact with its receptor RAGE-Toll-like receptor, Toll-like receptor TLR2 / TLR4, by activating MAPK. Many pathways, such as MyD88, finally activate NF- 魏 B(nuclear factor-kappa, NF- 魏 B, and induce inflammation. Previous studies have confirmed that NF- 魏 B is highly expressed in patients with nephrotic syndrome and is involved in the occurrence and development of primary nephrotic syndrome. At present, the correlation between primary nephrotic syndrome and inflammatory factor HMGB-1 and its changes in serum of patients with primary nephrotic syndrome have not been reported at home and abroad. The correlation between NF-KB and primary nephrotic syndrome is analyzed. To further explore the role of its in the pathogenesis of primary nephrotic syndrome. Objective: to investigate the role of HMGB-1 in primary nephrotic syndrome (PNS) by measuring the concentration of HMGB-1.NF- 魏 B in peripheral serum of patients with primary nephrotic syndrome (PNS) and analyzing the relationship between HMGB-1.NF- 魏 B and Nephrotic syndrome. Methods: from January 2013 to January 2014, 46 primary nephrotic syndrome (PNS) patients in Hunan Provincial people's Hospital were selected as NS group and 30 healthy persons as normal control group. Sex, age, serum albumin AIBN and cholesterol Cholium were collected from the two groups. The serum HMGB-1.NF- 魏 B concentrations in serum were measured by enzyme linked immunosorbent assay (Elisa), including triglyceride (TGG), low density lipoprotein (LDL), high density lipoprotein (HDL) and urinary protein quantitative C-reactive protein (UQRP). Pearson correlation analysis and multiple linear stepwise regression analysis were used to analyze the correlation between variables. Results: The concentration of HMGB-1.NF- 魏 B in 1.NS group was significantly higher than that in NC group (P 0.01). 2.Pearson correlation analysis showed that: HMGB-1 was positively correlated with urinary protein, triglyceride, total cholesterol, low density lipoprotein CRP, negatively correlated with albumin. NF-KB was positively correlated with urinary protein, triglyceride, total cholesterol, low density lipoprotein. There was a negative correlation between albumin and albumin. Multiple linear regression analysis showed that there was an independent correlation between urine protein and urine protein, and between NF- 魏 B and urine protein. 3. The correlation analysis showed that there was a positive correlation between HMGB-1 and NF- 魏 B, and the correlation coefficient was 0.793p0.01, the difference was statistically significant. Conclusion: 1. The expression of HMGB-1.NF- 魏 B was up-regulated in the serum of primary nephrotic syndrome, and there was a positive correlation between them. 2.HMGB-1 may play a role in the pathogenesis of primary nephrotic syndrome by affecting NF- 魏 B. 3. The quantity of proteinuria is closely related to inflammatory reaction in primary nephrotic syndrome.
【學(xué)位授予單位】：湖南師范大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R692

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