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目的:分析肾脏足细胞特异蛋白podocalyxin(PCX)的表达和尿足细胞数在紫癜性肾炎(Henoch-Schnlein purpura nephritis,HSPN)病理进展过程中的变化。方法:56例HSPN患儿为病例组,根据肾脏病理改变分为4组:HSPN Ⅱ(Ⅱa+Ⅱb)级组(n=10),Ⅲ(Ⅲa+Ⅲb)级组(n=21),Ⅳ级组(n=16)和Ⅴ级组(n=9);另取非肾脏疾病死亡病例尸检切取的肾脏标本4例作为正常肾组织对照组;同时收集8例健康儿童的晨尿作正常尿液对照组。应用免疫荧光方法检测PCX在4例正常肾组织及56例HSPN肾组织中的表达,并对其结果进行定量分析;同时检测8例健康儿童及56例HSPN患儿尿足细胞阳性的发生率和尿足细胞数。结果:在正常对照组和HSPN Ⅱ(Ⅱa+Ⅱb)级组的肾组织中,PCX表达完整,2组之间肾组织PCX阳性面积占肾小球面积的百分比差异无统计学意义(P>0.05);在HSPN Ⅲ(Ⅲa+Ⅲb)级﹑Ⅳ级和Ⅴ级组的肾组织中,PCX表达均有不同程度缺失,从Ⅲ(Ⅲa+Ⅲb)~Ⅴ级其表达依次下降,各组间比较差异有统计学意义(P<0.01);病理分级在Ⅲ(Ⅲa+Ⅲb)级以上的HSPN,尿中有PCX的阳性表达,提示尿中有足细胞存在;肾组织PCX荧光阳性面积占肾小球的百分比与尿中足细胞数呈负相关(r=-0.637,P<0.01)。结论:足细胞损伤在儿童HSPN病理进展中发挥一定作用;可以在一定程度上反映HSPN的病理损伤程度。
OBJECTIVE: To analyze the expression of podocalyxin (PCX), a specific protein of kidney podocyte, and the change of urinary podocyte number in the pathological progress of Henoch-Schnlein purpura nephritis (HSPN). Methods: Fifty-six children with HSPN were divided into four groups: HSPN Ⅱ (Ⅱa + Ⅱb) group (n = 10), Ⅲ (Ⅲa + Ⅲb) (N = 16) and Ⅴ group (n = 9). Four non-renal disease deaths were obtained from the autopsy of kidney specimens as normal control group. The morning urine of 8 healthy children was collected for normal urine Liquid control group. Immunofluorescence method was used to detect the expression of PCX in 4 normal kidneys and 56 HSPN kidney tissues, and the results were quantitatively analyzed. The incidence of urinary podocytes was also detected in 8 healthy children and 56 HSPN patients Urinary podocyte number. Results: The expression of PCX in renal tissue of normal control group and HSPN Ⅱ (Ⅱa + Ⅱb) group was intact. There was no significant difference in the percentage of PCX positive area between the two groups (P> 0.05) ). The expression of PCX in HSPN Ⅲ (Ⅲa + Ⅲb) ﹑ ﹑ ﹑ ﹑ and Ⅴ groups were all decreased to some extent. The expression of PCX decreased from Ⅲa + Ⅲb to Ⅴ, (P <0.01). The positive expression of PCX in the pathological gradeⅢ (Ⅲa + Ⅲb) grade HSPN and urine showed the presence of podocytes in the urine; the positive area of PCX fluorescence in renal tissue accounted for The percentage of balls was negatively correlated with urinary podocyte number (r = -0.637, P <0.01). Conclusion: Podocyte injury plays a role in the pathological progress of HSPN in children. It can reflect the degree of pathological damage of HSPN to a certain extent.