摘要
目的探讨血管性血友病因子（vwv）及P-选择素与狼疮肾炎的病理临床关系。方法应用免疫组织化学方法检测71例狼疮肾炎患者肾活检组织及10份正常对照肾组织中vWF及P0选择素的表达，结果与临床病理指标进行综合分析。采用单因素方差分析，Nemenyi秩和检验，Pearson相关分析进行统计学处理。结果vWF在正常对照组几乎元表达；狼疮肾炎组肾小球系膜基质，肾小管及间质血管内膜均可见vwF的阳性表达，以Ⅳ型表达最明显（0．30±0．10），与Ⅱ、Ⅲ型（0．12±0．05，0．22±0．14）相比，差异有统计学意义（x2=9．273，P〈0．05）。正常对照组仅有极少量P．选择素表达；狼疮肾炎组肾小球系膜区、肾小管和肾间质中均有P-选择素的广泛表达，以Ⅳ、V型显著（0．29±0．05，0．36±0．10），与Ⅱ、Ⅲ型（0．27±0．09，0．29±0．05）相比差异有统计学意义（P〈0．05）。肾组织中vwF的表达水平与肾组织活动指数、尿蛋白定量（24h）呈正相关（r分别为0．403，0．332，P均〈0．05）；肾组织中P-选择素的表达水平与肾组织活动指数、尿蛋白定量（24h）、系统性红斑狼疮疾病活动度（SLEDAI）呈正相关（r分别为0．283，0．453，0．297，P均〈0．05）；肾组织中vWF与P-选择素的表达呈明显正相关（r=0．371，P=0．001）。结论vwF及P-选择素参与狼疮肾炎病理发展过程，联合检测vwF、P-选择素有助于对狼疮肾炎严重程度的评估，进而为临床治疗提供依据。
Objective To investigate the clinic-pathological significance of yon Willebrand factor （vWF） and P-selectin expression in patients with lupus nephritis （LN）. Methods Biopsy specimens from 71 patients with LN whose disease course ranged from 2 months to 10 years were examined and scored according to a standardized method. SLE activity was evaluated by the SLE disease activity index （SLEDAI） and the British Isles Lupus Assessment Group index. Immunohistochemistry was used to detect the expressions of vWF and P-selectin in the renal tissue of LN patients and 10 normal controls. Of all the patients, 7 had World Health Organization type II, 10 had type m and 36 had WHO type IV, 18 had type V lupus nephritis. At the same time, the 24-h urine protein （UP） excretion level, the serum creatinine, the serum C3, C4, album level, antinuclear antibody （ANA）, anti-double stranded DNA and disease activity scores of all patients were detected. The relationship of their expressions with the clinicopathological parameters of lupus nephritis was analyzed. ANOVA, Nemenyi test and Pearson＇s analysis were used for statistical analysis. Results Compared with the control group, the in situ expressions of vWF and P-selectin in the lupus nephritis patients were significantly higher. Among these patients, renal expressions of vWF were higher in type IV （0.30±0.10） than those with type II and m （0.12±0.05, 0.22±0.14）（x2=9.273, x2=8.712, P〈0.05）, while the expressions of P-selectin were higher in type IV and V （0.29±0.05, 0.36±0.10）than those in type II and III （0.27±0.09, 0.29±0.05） （P〈0.05）. Correlation analysis indicated that vWF was correlated significantly with AI and 24-h UP （r=0.403, 0.332, P〈0.05）, while P-selectin was correlated significantly with the scores of activity index （AI）, 24-h UP excretion rate and SLEDAI （r=0.283, 0.453, 0.297, P〈0.05）. The expression of vWF was also closely related to P-selectin expressions （r=0.371, P=0.001）. Conclusion These results indicate that vWF and P-selectin play a critical role in the pathogenesis of LN. The detection of these two factors will provide a valuable clinical reference for renal damage. These information provide valuable clues for making better treatment regimen plan and achieving more favorable prognosis.
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2012年第5期313-316,F0003,共5页
Chinese Journal of Rheumatology
基金
基金项目：安徽省自然科学研究项目（KJ20078276）
