血清纤维化指标与肾脏病理关系探索(1)
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【摘要】 目的 探索血清纤维化指标与肾小球硬化和肾间质纤维化程度是否存在相关性。方法 43例行肾穿刺活检的慢性肾脏病患者，检测血清纤维化指标透明质酸(HA)、层粘蛋白(LN)、Ⅲ型前胶原(PCⅢ)水平。分析判断血清HA、LN 、PCⅢ水平与肾小球硬化和肾间质纤维化程度的关系。结果 无1例4级肾小球硬化和4级肾间质纤维化。1级(33例)和2级(5例)肾小球硬化的患者血清HA、LN、PCⅢ水平差异无统计学意义。3级(5例)肾小球硬化的血清HA、LN、PCⅢ水平较1级和2级患者均升高。1级(31例)和2级(7例)肾间质纤维化的患者血清HA、LN、PCⅢ水平差异无统计学意义。3级(5例)肾间质纤维化的血清HA、LN、PCⅢ水平较1级和2级患者均升高。结论 血清HA、LN、PCⅢ水平水平升高可能提示肾小球硬化或肾间质纤维化比较严重。
【关键词】 透明质酸;层粘蛋白;Ⅲ型前胶原;肾小球硬化;肾间质纤维化
Explore the relationship of Sserum fibrosis markers and renal pathology XU Hai,shan, CHEN Kai,yi, LIN Dan,hua, et al. Department of Nephrology，The Affiliated Hospital of Putian College, Fujiang 351100, China
【Abstract】 Objective To explore the relationship of the serum fibrosis markers and renal pathology. Methods 43 patients of chronic kidney disease who were made renal biopsy were detect their serum HA, LN, PC Ⅲ，then analyzed the relationship of the serum fibrosis markers and glomerular sclerosis, the serum fibrosis markers and renal interstitial fibrosis. Results No one was level 4 of glomerulosclerosis and renal interstitial fibrosis. The level of serum HA, LN, PC Ⅲ had no statistical significance in level 1 (33 cases ) and level 2 (5 cases)patients with glomerulosclerosis. Compared with level 1 and level 2 , the level of serum HA, LN, PC Ⅲ were higher in level 3 (5 cases) patients with glomerulosclerosis. The level of serum HA, LN, PC Ⅲ had no statistical significance in level 1 (31 cases ) and level 2 (7 cases)patients with renal interstitial fibrosis. Compared with level 1 and level 2 , the level of serum HA, LN, PC Ⅲ were higher in level 3 (5 cases) patients with renal interstitial fibrosis.Conclusion Elevated the level of serum HA, LN, PC Ⅲ may indicate more serious glomerular sclerosis or interstitial fibrosis.
【Key words】 Hyaluronic acid; Laminin; procollagen Ⅲ; Glomerulosclerosis ;Renal interstitial fibrosis
肾小球硬化和肾间质纤维化是慢性肾脏病进展共同病理过程，进一步可发展至慢性肾功能衰竭甚至尿毒症。如何早期发现肾小球硬化和肾间质纤维化并予以治疗,从而逆转、阻断或者延缓肾病进展,是保护肾脏功能的最重要一环。长期以来, 肾小球硬化和肾间质纤维化诊断离不开肾穿刺活检,这种损伤性检查具有明显缺陷。近10 多年来,国内外一直在寻找非损伤性诊断方法,特别是血清学诊断指标 ......
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