临床儿科杂志 ›› 2016, Vol. 34 ›› Issue (10): 761-.doi: 10.3969/j.issn.1000-3606.2016.10.012

• 综合报道 • 上一篇    下一篇

狼疮性肾炎患儿肾血管损害与心肌素浓度变化

宁春艳 1,2 ,党西强 1 ,宋芳 2 ,易著文 1 ,何小解 1   

  1. 1.中南大学湘雅二医院儿童肾脏病研究室(湖南长沙 410011); 2.长沙市第三医院儿科(湖南长沙 410011)
  • 收稿日期:2016-10-15 出版日期:2016-10-15 发布日期:2016-10-15
  • 通讯作者: 何小解 E-mail:hexj7150@163.com

Correlation between vascular damage and blood myocardin in children with lupus nephritis

NING Chunyan 1,2, DANG Xiqiang1, SONG Fang2, YI Zhuwen1, HE Xiaojie1   

  1. 1. Laboratory of Pediatric Nephropathy, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; 2. Department of Pediatric, The Third Hospital of Changsha, Changsha 410011, Hunan, China
  • Received:2016-10-15 Online:2016-10-15 Published:2016-10-15

摘要: 目的 研究狼疮性肾炎(LN)患儿不同血管损害程度时心肌素浓度的变化。方法 选取经皮穿刺活检组织常 规免疫荧光、光镜及电镜检查确诊的LN患儿49例,30名健康体检儿童为正常对照组。依据ISN/RPS 2003 LN病理分型标 准进行病理分型;依据Katafuchi评价方法对肾小球与肾小管间质损害进行半定量积分,同时对血管损害进行评价;采用 双抗体夹心法检测血清心肌素含量。结果 LN患儿的肾小球损害积分、肾间质损害积分均随病理分型的加重而增高,差 异有统计学意义(P < 0.05);肾小球损害与肾间质损害呈正相关(r = 0.96, P < 0.01);血管损害程度与肾小球损害程度、 肾间质损害程度有关,与临床检验指标无关。按肾血管损害程度分组,血管损害轻度组、中度组、重度组及正常对照儿童 之间外周血心肌素浓度差异有统计学意义(F = 378.61, P < 0.001),中度组、重度组明显低于正常对照与轻度损害组,差 异均有显著统计学意义(P < 0.01);正常对照与轻度损害组之间差异无统计学意义(P > 0.05)。 按病理类型分组,正常对 照与各病理类型分组间外周血心肌素浓度差异有统计学意义(F = 626.793, P < 0.01),Ⅱ、Ⅲ、Ⅲ+Ⅴ、Ⅳ、 Ⅳ+Ⅴ型患儿 外周血心肌素依次降低,组间差异均有统计学意义(P均 < 0.05)。 结论 LN患儿血清中心肌素的浓度可在一定程度上反 映其肾脏血管损害情况,提高心肌素的浓度可能有助于血管损害的修复。

Abstract: Objective To investigate the changes in the concentration of myocardin in children with lupus nephritis (LN) under different degree of vessel damage. Methods Forty-nine children diagnosed with LN by routine tissue immunofluorescence, light microscope, and electron microscope were included, and 30 healthy children were included as control group. The pathological classifications were performed according to the ISN/RPS 2003 LN pathological classification criterion. According to the Katafuchi evaluation method, the semi quantitative assessment of glomerular and kidney tubule damage was carried out, and the degree of vascular damage was evaluated at the same time. Double antibody sandwich method was used to detect the concentration of serum myocardin. Results The glomerular and kidney tubules damage in children with LN were significantly aggravated with higher pathological classification (P < 0.05). Glomerular damage was positively correlated with renal interstitial damage (r =0.96, P < 0.01). The degree of vascular damage was related to the degree of glomerular injury and renal interstitial injury, while it was no related with the results of clinical tests. There were different concentrations of myocardin among mild-, moderate-, severe-vessel damage and control groups (F =378.61, P < 0.001), and the concentration of myocardin in moderate- and severe-vessel damage groups were obviously lower than those in control group and mild-vessel damage group (P < 0.01) while there was no difference between control group and mild-vessel damage group (P > 0.05). According to pathological type, there were significant differences in the concentration of myocardial between control group and different pathological types (F =626.793, P < 0.01). From Ⅱ, Ⅲ, Ⅲ+Ⅴ,Ⅳ to Ⅳ+Ⅴ, the concentrations of myocardial were decreased systematically, and there were statistic differences between groups (P all < 0.05). Conclusion The concentration of myocardin in children with LN can reflect the renal vascular damage to a certain extent. Elevation of myocardin concentration may be helpful for the repair of vascular damage.