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目的研究内皮素-1(ET-1)在过敏性紫癜(HSP)患儿肾组织中的分布、表达变化及其与肾脏病理损害的关系,探讨ET-1在紫癜性肾炎(HSPN)发病及病理进展中的作用。方法分别以免疫组织化学及原位杂交方法检测51例不同病理分级HSP患儿急性期组与恢复期组肾组织ET-1蛋白及mRNA表达,10例正常肾组织为对照组。结果1.正常肾组织及HSP患儿肾组织中均有ET-1表达。正常肾脏肾小球、系膜ET-1仅微弱表达;远端肾小管表达多于近端,间质无表达;HSP患儿肾组织ET-1表达信号明显增多,肾小管表达比对照组增多,主要见于血管内皮细胞、上皮细胞和系膜细胞(P均<0.05);蛋白及mRNA的表达呈显著正相关(r=0.764 P<0.05);2.急性期组与恢复期组不同病理分级HSPN患儿肾组织ET-1表达均存在明显差异,Ⅰ-Ⅳ级病理损害者ET-1表达水平随病理加重而表达增加,病理表现为Ⅴ-Ⅵ级者,ET-1表达与上述各组比较有所降低,但仍较对照组增多,差异有统计学意义(P<0.05);3.与急性期组相比,恢复期组ET-1表达明显减低,但仍高于对照组(P<0.05);4.尿常规检查正常组与异常组,ET-1表达无明显差异(P>0.05)。结论肾组织能通过自分泌方式产生ET-1;ET-1表达水平与肾脏病理损伤程度有一定关系,在HSPN发病及病理进展中发挥一定作用;临床上应积极行肾组织活检确立HSPN的诊断。
Objective To investigate the distribution and expression of endothelin-1 (ET-1) in renal tissues of children with Henoch-Schonlein purpura (HSP) and its relationship with renal pathological lesions, and to explore the role of ET-1 in the pathogenesis of purpura nephritis (HSPN) The role of pathological progress. Methods Immunohistochemistry and in situ hybridization were used to detect the expression of ET-1 protein and mRNA in 51 cases of acute stage group and convalescent stage of HSP group, and 10 cases of normal kidney tissue as control group. Results 1. The expression of ET-1 in the kidney of normal kidneys and HSP children. The normal renal glomerulus and mesangial ET-1 expression was only weakly expressed; the expression of distal tubular tubules was more than that of the proximal and interstitial tissues; the expression of ET-1 in renal tissues was significantly increased and the expression of renal tubules was increased , Mainly in vascular endothelial cells, epithelial cells and mesangial cells (all P <0.05). There was a significant positive correlation between the expression of protein and mRNA (r = 0.764, P <0.05) .2. The pathological grading The expression of ET-1 in renal tissues of HSPN patients were significantly different. The expression of ET-1 in grade Ⅰ-Ⅳ pathological changes was increased with the pathological changes, and the pathological changes were grade V-Ⅵ. The expression of ET-1 in each group (P <0.05) .3 Compared with the acute phase group, the expression of ET-1 in convalescent group decreased significantly, but still higher than the control group (P <0.05) <0.05) .4. There was no significant difference in ET-1 expression between normal group and abnormal group (P> 0.05). Conclusion The renal tissue can produce ET-1 through autocrine. The expression level of ET-1 has a certain relationship with the degree of renal pathological injury, and plays a role in the pathogenesis and pathological progress of HSPN. The clinical diagnosis of HSPN should be established by renal biopsy .