本文選題：IgA腎病 + 補(bǔ)體活化　； 參考：《青島大學(xué)》2014年碩士論文

【摘要】：目的：研究不同的補(bǔ)體活化類(lèi)型在IgA腎病(IgA Nephropathy, IgAN)患者血液及尿液中的活化及其致病作用,拓展IgAN的發(fā)病機(jī)制理論。 方法：疾病組IgAN患者30例,疾病陽(yáng)性對(duì)照組狼瘡性腎炎(Lupus Nephritis, LN)患者8例,本院查體中心30例健康人作正常對(duì)照組。采用商品化的ELISA試劑盒檢測(cè)IgAN患者及對(duì)照組血清中三條補(bǔ)體激活途徑的標(biāo)志性成分：三條補(bǔ)體活化通路中的共同裂解產(chǎn)物C3a、C5a,及可溶型終末期膜攻擊復(fù)合物sC5b-9,補(bǔ)體經(jīng)典途徑標(biāo)志物Clq,凝集素途徑標(biāo)志物L(fēng)-ficolin (FCN2),經(jīng)典途徑及凝集素途徑激活后的共同產(chǎn)物C4d,補(bǔ)體替代途徑激活標(biāo)志產(chǎn)物Bb因子,并檢測(cè)尿液中的補(bǔ)體經(jīng)典途徑標(biāo)志物Clq。將IgAN組按照腎臟病理的Lee氏分級(jí)進(jìn)行分組,Lee氏Ⅰ-Ⅲ級(jí)為一組,Lee氏Ⅳ-Ⅴ級(jí)定為損傷較重的組,比較兩組間的補(bǔ)體激活差異。分析三條途徑補(bǔ)體激活的差異與腎組織病理結(jié)果及臨床生化指標(biāo)的相關(guān)性。 結(jié)果：在IgAN、LN和正常對(duì)照組中,上述檢測(cè)的補(bǔ)體因子呈現(xiàn)出顯著差異(P0.05)。三條補(bǔ)體通路共同產(chǎn)物C3a、C5a及sC5b-9在IgAN組與LN組間無(wú)差異,除C5a外,IgAN組和LN組水平均高于正常對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。IgAN組血清Clq、尿液Clq濃度均較正常對(duì)照組明顯升高,差異有統(tǒng)計(jì)學(xué)意義(P0.05),IgAN組的尿液Clq水平明顯低于LN組(P0.05)。IgAN組與LN組的FCN2水平均明顯高于正常對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),此兩組間比較無(wú)差別。C4d三組間兩兩比較均有統(tǒng)計(jì)學(xué)差異(P＜0.05),IgAN組與LN組皆明顯高于正常對(duì)照組。IgAN患者Lee氏Ⅳ-Ⅴ級(jí)組的血液及尿液Clq均明顯低于Lee氏Ⅰ～Ⅲ級(jí)組(P0.05)。補(bǔ)體因子與臨床指標(biāo)間存在不同程度的相關(guān)性,其中Bb、C3a等補(bǔ)體裂解產(chǎn)物與血清肌酐間呈正相關(guān)關(guān)系(r=0.551, P=0.041; r=0.547, P=0.008),FCN2與尿紅細(xì)胞計(jì)數(shù)間呈正相關(guān)關(guān)系(r=0.416,P=0.025),尿Clq與血清肌酐間呈顯著正相關(guān)(r=0.518,P=0.033)。 結(jié)論：IgAN患者血液中存在著補(bǔ)體替代途徑及凝集素途徑的活化,可能存在著補(bǔ)體經(jīng)典途徑的活化,補(bǔ)體激活參與臨床及腎臟病理?yè)p傷,補(bǔ)體激活程度影響臨床及病理?yè)p傷程度。
[Abstract]:Objective: to study the activation and pathogenicity of different types of complement activation in blood and urine of patients with IgA nephropathy (IgAN), and to explore the pathogenesis of IgAN. Methods: 30 patients with IgAN in the disease group, 8 patients with lupus nephritis (LN) in the positive control group and 30 healthy persons in the examination center of our hospital served as the normal control group. Commercial Elisa kit was used to detect the signature components of three complement activation pathways in IgAN patients and control group: the co-cleavage product C3aOC5afrom three complement activation pathways, and soluble end-stage membrane attack complex sC5b-9, complement. Classical pathway marker Clq, agglutinin pathway marker L-ficolin (FCN2), common product C4d after activation of classical pathway and lectin pathway, Bb factor, activation marker of complement substitution pathway, The classical complement pathway marker Clq. in urine was also detected. According to the Lee's grade of renal pathology, IgAN group was divided into two groups: Lee's grade 鈪，

本文編號(hào)：2100026