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目的分析糖尿病肾病患者肾小管上皮细胞DcR2、p16表达变化及其与肾组织损伤程度和肾功能的相关性。方法选取60例糖尿病肾病患者为研究组,60例同期行肾脏肿瘤切除术取其病灶旁正常肾组织的患者为对照组,采用免疫组化法、免疫荧光法对DcR2、p16表达变化进行检测。分析肾小管上皮细胞DcR2、p16表达阳性率与临床相关资料的相关性,并评估肾小管上皮细胞DcR2、p16表达阳性率与肾组织损伤程度的相关性。结果研究组患者肾小管上皮细胞DcR2、p16表达阳性率均高于对照组患者(χ~2=9.35,15.94,均P<0.01),且研究组进展期糖尿病肾病患者肾小管上皮细胞DcR2、p16表达阳性率均高于早期糖尿病肾病患者(χ~2=11.96,14.97,均P<0.01)。研究组患者肾小管上皮细胞DcR2、p16表达变化与估计的肾小球滤过率呈负相关,与患者收缩压、尿蛋白定量、尿蛋白/肌酐、尿素氮(BUN)、甘油三酯(TG)、胱抑素c(Cyc)及血肌酐(Scr)呈正相关。研究组患者肾小管上皮细胞DcR2、p16表达变化与患者肾小管萎缩与间质纤维化、肾间质炎症、系膜增生及肾小球硬化病变程度存在显著性关系(P均<0.01)。结论糖尿病肾病患者肾小管上皮细胞DcR2、p16的表达变化与其肾组织损伤程度及肾功能均存在显著性关系,在肾组织损伤程度及肾功能中起到重要作用。
Objective To analyze the expression of DcR2 and p16 in renal tubular epithelial cells of patients with diabetic nephropathy and its relationship with renal injury and renal function. Methods Sixty diabetic patients with diabetic nephropathy were selected as the study group. Sixty patients with nephrectomized nephrectomy were enrolled as the control group. Immunohistochemistry and immunofluorescence were used to detect the expression of DcR2 and p16. The correlation between the positive rate of DcR2 and p16 expression in renal tubular epithelial cells and clinical related data was analyzed. The correlation between the positive rate of DcR2 and p16 expression in renal tubular epithelial cells and the degree of renal tissue injury was also evaluated. Results The positive rates of DcR2 and p16 in renal tubular epithelial cells in study group were significantly higher than those in control group (χ ~ 2 = 9.35 and 15.94, all P <0.01), and the expression of DcR2 and p16 in renal tubular epithelial cells in advanced diabetic nephropathy group The positive expression rate was higher in patients with early diabetic nephropathy (χ ~ 2 = 11.96 and 14.97, all P <0.01). The changes of DcR2 and p16 expression in the study group were negatively correlated with the estimated glomerular filtration rate. The systolic blood pressure, proteinuria, urine protein / creatinine, blood urea nitrogen (BUN), triglyceride (TG) ), Cystatin C (Cyc) and serum creatinine (Scr) were positively correlated. The expression of DcR2, p16 in renal tubular epithelial cells in study group was significantly correlated with the degree of renal tubular atrophy and interstitial fibrosis, interstitial inflammation, mesangial proliferation and glomerulosclerosis (all P <0.01). Conclusion The expression of DcR2 and p16 in renal tubular epithelial cells of patients with diabetic nephropathy has a significant relationship with the extent of renal tissue damage and renal function, and plays an important role in the degree of renal tissue damage and renal function.