【摘要】：目的探討CD20在不同腎功能狀態(tài)的成人IgA腎病(IgA nephropathy,IgAN)患者腎組織中的表達及其與腎臟臨床病理特征、預(yù)后的關(guān)系。方法將47例IgAN依據(jù)改良MDRD公式評估腎小球濾過率(estimated glomerular filtration rate,eGFR),將入選患者分為三組:A組(腎功能正�；蜉p度受損):eGFR60 ml/min;B組(腎功能中度受損):eGFR 30~60 ml/min;C組(腎功能重度受損,不含尿毒癥):eGFR 10~30 ml/min。按Katafuchi評分標準進行腎活檢病理評分,應(yīng)用免疫組化法檢測三組腎穿刺標本中CD20的表達,并對所有患者進行隨訪,復(fù)查相關(guān)臨床指標。結(jié)果 CD20主要表達于IgAN患者腎組織皮質(zhì)區(qū)腎小管管周間質(zhì)B淋巴細胞胞膜。與eGFR60 ml/min組相比,eGFR 30~60 ml/min組、eGFR 10~30 ml/min組CD20表達量明顯升高,差異有統(tǒng)計學意義(P值分別為0.002,0.001);腎組織中CD20表達量與eGFR呈負相關(guān)(r=-0.697,P0.001),與24 h尿蛋白定量、血清肌酐、腎小管間質(zhì)積分呈正相關(guān)(r值分別為0.524、0.647、0.769;P均0.001)。結(jié)論腎組織中CD20的表達量與IgAN患者腎臟病理損傷指數(shù)、24 h尿蛋白定量、腎功能狀態(tài)均密切相關(guān),提示檢測IgAN患者腎組織中CD20表達對了解腎臟病變程度、評估患者預(yù)后有一定臨床價值。
[Abstract]:Objective to investigate the expression of CD20 in renal tissues of adult IgA nephropathy (IgA nephropathy,IgAN) patients with different renal function and its relationship with renal clinicopathological features and prognosis. Methods 47 patients with IgAN were divided into three groups: group A (normal or mild impairment of renal function): eGFR60 ml/min;. The glomerular filtration rate (estimated glomerular filtration rate,eGFR) was evaluated according to the modified MDRD formula. The patients were divided into three groups: group A (normal or mild impairment of renal function); Group B (moderate impairment of renal function): eGFR 30 / 60 ml/min;C group (severe impairment of renal function, excluding uremic): eGFR 10 / 30 ml/min. The pathological score of renal biopsy was evaluated according to Katafuchi scoring standard. The expression of CD20 in renal biopsy specimens of three groups was detected by immunohistochemical method. All the patients were followed up and the related clinical indexes were reexamined. Results CD20 was mainly expressed in the B cell membrane of renal tubulointerstitial B cells in the renal cortex of patients with IgAN. Compared with eGFR60 ml/min group, the expression of CD20 in eGFR 30 / 60 ml/min group and eGFR 10 / 30 ml/min group was significantly higher than that in eGFR group (P = 0.002, P < 0.001). The expression of CD20 in renal tissue was negatively correlated with eGFR (r = 0.697, P0.001), and positively correlated with 24 h urinary protein, serum creatinine and tubulointerstitial score (r = 0.524,0.647, 0.769, respectively, P 0.001). Conclusion the expression of CD20 in renal tissue is closely correlated with renal pathological injury index, 24-hour urinary protein quantity and renal function status in IgAN patients. It is suggested that detecting the expression of CD20 in renal tissue of IgAN patients is helpful to understand the degree of renal lesion. It is of clinical value to evaluate the prognosis of the patients.
【作者單位】： 北京大學深圳醫(yī)院腎內(nèi)科;江蘇省鎮(zhèn)江市第一人民醫(yī)院腎內(nèi)科;
【分類號】：R692.31
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本文編號：2447511