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【目的】:探讨原发性肾病综合症患者(PNS)肾组织及尿液单核细胞趋化因子(MCP-1)表达水平及其在肾小管间质损伤中的意义。【方法】用免疫组化法检测56例PNS患者肾组织MCP-1的蛋白表达,ELISA法检测治疗前及治疗后3个月时尿液MCP-1质量浓度。【结果】正常肾组织无MCP-1表达,肾病患者均有不同程度表达,表达部位主要在肾小管上皮细胞与肾间质,肾组织及尿液MCP-1表达水平均显著高于对照组。强的松或强的松+环磷酰胺治疗3个月后尿液MCP-1表达水平显著降低。微小病变患者肾组织及尿液MCP-1表达水平显著低于其它病理类型患者,膜增殖性性肾炎患者显著高于其它类型患者。治疗后未完全缓解患者尿液与肾小管间质MCP-1表达水平显著高于完全缓解患者。肾组织及尿液MCP-1表达水平与肾脏病理类型、肾小管间质病变程度及血清肌酐水平、肌酐清除率显著相关。【结论】MCP-1在PNS患者肾小管间质病变发生机制中起重要作用,检测肾组织及尿液MCP-1表达水平对PNS患者病情、治疗反应、预后判断及病理诊断有一定价值。
【Objective】 To investigate the expression of monocyte chemoattractant protein (MCP-1) in renal tissue and urine of patients with primary nephrotic syndrome (PNS) and its significance in tubulointerstitial injury. 【Methods】 The protein expression of MCP-1 in renal tissue of 56 patients with PNS was detected by immunohistochemistry and the concentration of MCP-1 in urine before treatment and 3 months after treatment by ELISA. [Results] The expression of MCP-1 in normal renal tissue was not found in normal renal tissue, and the expression of MCP-1 in renal tubular epithelial cells, renal interstitium and urine was significantly higher than that in control group. Prednisone or prednisone + cyclophosphamide after 3 months of urine MCP-1 expression was significantly lower levels. The expression of MCP-1 in renal tissues and urine of patients with minimal change was significantly lower than those in other pathological types, and the patients with membranoproliferative glomerulonephritis were significantly higher than those in other types of patients. The level of MCP-1 in urine and tubulointerstitium was significantly higher than that in patients without complete remission after treatment. The expression of MCP-1 in renal tissue and urine was significantly correlated with renal pathological type, degree of tubulointerstitial lesions, serum creatinine and creatinine clearance. 【Conclusion】 MCP-1 plays an important role in the pathogenesis of tubulointerstitial lesions in patients with PNS. Detecting the expression of MCP-1 in renal tissue and urine has certain value for the patients with PNS, the treatment response, prognosis and pathological diagnosis.