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目的：观察血管细胞粘附分子－１（ＶＣＡＭ－１）在不同类型新月体肾炎患者肾组织中的分布，分析ＶＣＡＭ－１在新月体肾炎发病机制中的作用及其在诊断与治疗中的应用价值。方法：利用肾活检组织，采用免疫组化方法，观察ＶＣＡＭ－１、ＣＤ４＋、ＣＤ８＋和ＣＤ６８＋细胞在不同患者中的分布及甲基强的松龙（ＭＰ）冲击治疗后的变化。结果：不同类型新月体肾炎肾小球新月体处ＶＣＡＭ－１均呈强阳性表达。ＶＣＡＭ－１表达增加与肾小球毛细血管袢坏死的发生无明显相关性。新月体肾炎患者肾小管及间质细胞ＶＣＡＭ－１的表达明显高于正常人，其表达程度与间质炎性细胞浸润间无明显相关性，而且不同类型患者间差异不明显。ＭＰ冲击治疗能明显减少肾组织炎性细胞浸润程度，但对ＶＣＡＭ－１的表达无明显影响。结论：ＶＣＡＭ－１是介导新月体肾炎新月体形成的一个重要因素。新月体肾炎存在肾小管上皮及间质细胞ＶＣＡＭ－１的异常表达，ＭＰ冲击治疗对其无明显影响。
OBJECTIVE: To observe the distribution of vascular cell adhesion molecule-1 (VCAM-1) in different types of patients with crescentic glomerulonephritis and to analyze the role of VCAM-1 in the pathogenesis of crescentic nephritis and its role in diagnosis and treatment The application value. Methods: The distribution of VCAM-1, CD4 +, CD8 + and CD68 + cells in different patients and the changes after the treatment with methylprednisolone (MP) were observed by immunohistochemistry. Results: The expression of VCAM-1 in glomerulus crescent of different types of crescentic glomerulus was strongly positive. There was no significant correlation between the increased expression of VCAM-1 and the occurrence of glomerular capillary loop necrosis. The expression of VCAM-1 in renal tubular and interstitial cells in patients with crescentic glomerulonephritis was significantly higher than that in normal people, and there was no significant correlation between the expression level of VCAM-1 and interstitial inflammatory cell infiltration in patients with crescentic glomerulonephritis. There was no significant difference between different types of patients. MP shock treatment can significantly reduce the degree of inflammatory cell infiltration of renal tissue, but no significant effect on the expression of VCAM-1. Conclusion: VCAM-1 is an important factor in the formation of crescentic neovascularization. There was abnormal expression of VCAM-1 in renal tubular epithelial cells and interstitial cells in crescentic glomerulonephritis, and MP impact treatment had no significant effect on it.