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目的探讨血管内皮生长因子(VEGF)及其受体Ⅱ(Flk-1)和血栓调节蛋白(TM)在乙型肝炎病毒相关性肾炎(HBV-GN)中的表达情况,以及它们在疾病进展中的作用。方法以南京军区福州总医院经肾活检确诊的68例HBV-GN患者为研究对象,以8例行肾脏切除的肾脏肿瘤患者的正常肾组织为对照组,采用免疫组化方法检测肾活检组织中VEGF、Flk-1和TM的表达情况,分析其变化与临床病理指标的关系。结果 VEGF和Flk-1在HBV-GN中的表达均明显高于正常对照组,随着肾小球病变程度的加重,VEGF、Flk-1及TM的表达逐渐减少,在重度病变组表达最少(P<0.01)。硬化组中肾小球内VEGF和TM的表达呈正相关(r=0.701,P<0.05)。结论 VEGF及其受体在HBV-GN的进展中发挥重要作用,在病变早期可能上调,促进蛋白尿形成,而病变严重者则表达下降,影响血管生成再生,导致细胞外基质合成增多。
Objective To investigate the expression of vascular endothelial growth factor (VEGF) and its receptor Ⅱ (Flk-1) and thrombomodulin (TM) in hepatitis B virus-associated nephritis (HBV-GN) Role. Methods Sixty-eight patients with HBV-GN confirmed by renal biopsy in Fuzhou General Hospital of Nanjing Military Area Command were enrolled in this study. Eight normal kidney tissues from patients with nephrectomized renal tumors were used as control group. Immunohistochemistry VEGF, Flk-1 and TM expression, analyze the relationship between changes and clinicopathological parameters. Results The expression of VEGF and Flk-1 in HBV-GN was significantly higher than that in the normal control group. The expression of VEGF, Flk-1 and TM decreased gradually as the degree of glomerular lesions increased, and the expression of VEGF and Flk- P <0.01). There was a positive correlation between the expressions of VEGF and TM in the sclerosis group (r = 0.701, P <0.05). Conclusions VEGF and its receptors play an important role in the progress of HBV-GN, which may be up-regulated in the early stages of the disease and promote the formation of proteinuria. In severe cases, the expression of VEGF and its receptors may be decreased, which may affect the regeneration of angiogenesis and lead to the increase of extracellular matrix synthesis.