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目的探讨原发性IgA肾病(IgAN)患者肾组织单核细胞趋化蛋白-1(MCP-1)的表达变化。方法选择经皮肾组织穿刺活检确诊为IgAN的患者40例。根据肾脏病理Lee氏分级(Ⅰ～Ⅴ级)将纳入研究的患者分为2组:A组20例,病理分级为Ⅰ～Ⅲ级;B组20例,病理分级为Ⅳ～Ⅴ级。对照组20例标本选取手术切除的肾肿瘤、肾囊肿患者远离病变组织的正常肾组织。同时将肾组织的肾小管和肾间质按照Katafuchi标准分为无间质病变组21例,轻度间质病变组8例,中度间质病变组19例和重度间质病变组12例。均采用免疫组织化学方法测定其肾组织中MCP-1的表达(以灰度值反映),观察其肾组织切片的染色强度及染色透光度,灰度值大则MCP-1表达少,反之则表达多。结果根据肾脏病理Lee分级分组,各组灰度值比较:B组灰度值(68.08±2.37)与A组灰度值(74.50±3.27)比较、B组与对照组灰度值(81.98±3.21)比较、A组与对照组比较,差异均有统计学意义(Pa<0.01);根据Katafuchi标准分组,无间质病变组、轻度间质病变组、中度间质病变组及重度间质病变组灰度值分别为82.03±3.13、76.44±2.01、71.49±1.69、66.54±1.23,各组比较差异均有统计学意义(Pa<0.01)。结论 MCP-1可反映原发性IgAN患者肾组织的病理损害程度,且表达水平与肾组织损害程度有关。
Objective To investigate the expression of monocyte chemoattractant protein-1 (MCP-1) in primary IgA nephropathy patients. Methods Forty patients with IgAN diagnosed by percutaneous renal biopsy were selected. The included patients were divided into two groups according to the Lee’s grading of renal pathology (grade Ⅰ ~ Ⅴ): 20 cases in group A and pathological grade Ⅰ ~ Ⅲ; group B in 20 cases with grade Ⅳ ~ Ⅴ. 20 cases of control group selected surgical excision of renal tumors, patients with renal cysts away from the diseased normal renal tissue. At the same time, renal tubules and renal interstitium were divided into 21 cases of non-interstitial disease group, 8 cases of mild interstitial disease group, 19 cases of moderate interstitial disease group and 12 cases of severe interstitial disease group according to Katafuchi criteria. Immunohistochemistry was used to determine the expression of MCP-1 in renal tissue (reflected in gray value), and the staining intensity and staining transparency of renal tissue sections were observed. Many expressions. The results were grouped according to the pathological type of kidney Lee. The gray value of each group was compared: the gray value of group B (68.08 ± 2.37) and the gray value of group A (74.50 ± 3.27), the gray value of group B and control (81.98 ± 3.21 (P <0.01). According to the Katafuchi criteria, the group of asexual lesions, mild interstitial lesions, moderate interstitial lesions and severe interstitial lesions The grayscale values of the lesion group were 82.03 ± 3.13, 76.44 ± 2.01, 71.49 ± 1.69, 66.54 ± 1.23, respectively. The differences among the groups were statistically significant (Pa <0.01). Conclusion MCP-1 can reflect the degree of pathological damage in renal tissue of patients with primary IgAN, and the expression level is related to the degree of renal damage.