CAJ | 학술논문

目的探讨先天性肾积水患儿肾脏水通道蛋白2(aquaporin-2,AQP2)表达水平及其尿液AQP2表达水平之间的相关性.方法选取20例单侧先天性肾盂输尿管连接处梗阻肾积水肾脏,其中轻度和重度积水肾脏各10例,并选取8例正常肾脏作为对照组.应用免疫组织化学方法检测肾脏AQP2表达水平,并采用酶联免疫吸附法(ELISA)检测其尿液中AQP2浓度.结果 AQP2阳性着色位于肾脏集合管主细胞胞膜和胞质.积水肾脏AQP2表达水平下降和其尿液中AQP2表达水平下降及尿渗透压下降相一致.重度积水组显著低于轻度积水组,重度和轻度积水组均显著低于正常对照组(P＜0.05).积水肾脏AQP2表达水平与其尿液AQP2表达水平以及尿渗透压均有显著正相关性(分别为r尿AOY2=0.706,P＜0.05;r尿渗透压=0.810,P＜0.05).结论随着先天性.肾积水患儿积水程度增加,其肾脏AQP2表达水平和其尿液AQP2浓度及尿渗透压均明显下降.检测尿液AQP2浓度可间接反映肾脏中AQP2的表达情况,为临床评估肾脏浓缩稀释功能损害程度提供依据.
목적 탐토선천성신적수환인신장수통도단백2(aquaporin-2,AQP2)표체수평급기뇨액AQP2표체수평지간적상관성.방법 선취20례단측선천성신우수뇨관련접처경조신적수신장,기중경도화중도적수신장각10례,병선취8례정상신장작위대조조.응용면역조직화학방법검측신장AQP2표체수평,병채용매련면역흡부법(ELISA)검측기뇨액중AQP2농도.결과 AQP2양성착색위우신장집합관주세포포막화포질.적수신장AQP2표체수평하강화기뇨액중AQP2표체수평하강급뇨삼투압하강상일치.중도적수조현저저우경도적수조,중도화경도적수조균현저저우정상대조조(P＜0.05).적수신장AQP2표체수평여기뇨액AQP2표체수평이급뇨삼투압균유현저정상관성(분별위r뇨AOY2=0.706,P＜0.05;r뇨삼투압=0.810,P＜0.05).결론 수착선천성.신적수환인적수정도증가,기신장AQP2표체수평화기뇨액AQP2농도급뇨삼투압균명현하강.검측뇨액AQP2농도가간접반영신장중AQP2적표체정황,위림상평고신장농축희석공능손해정도제공의거.
Objective To investigate the relationship between the expression of aquaporin-2(AQP2) in hydronephrotic kidney(HNK)and urine in children with congenital hydtonephrosis.Methods Twenty patients with congenital unilateral pyeloureteric junction obstruction(PUJO)were chosen for this study,in whom 10 suffered mild hydronephrosis and 10 suffered severe hydronephrosis,with the mean age of 61.2±30.7 months.Eight nortnal ehildren served as controls,with the mean age of 58.9±34.2 months.The expression of AQP2 in HNK tissue was determined by immunohistochemisty,and the AQP2 levelin urine was determined by enzyme-linked immunosorbent assay(ELISA).Results Positive immunoreactivity of AQP2 was found in the apical membrane and intracellular vesicles of the principal cells in collecting ducts.The decreasing of HNK tissue and urine AQP2 expression level was consistent with the decreasing of urinary osmotic pressure in patients with hydronephrosis.The AQP2 expression in severe hydronephrotic group was significantly lower than that in mild hydronephrotic group(P＜0.05),and AQP2 expression in abovementioned two groups was significantly 10wer than that in the controls(P＜0.05).A positive correlation between the expression level of AQP2 in HNK tissue and urinary AQP2 level,and urinary osmotic pressure were found(r=0.706,P＜0.05;r=0.810,P＜0.05).Conclusions With the malignancy of hydronephrosis,the expression of AQP2 in HNK tissue and the urinary AQP2 levels and the urinary osmotic pressure have parallel decreasing,indicating the change of urinary AQP2 level may be used as a marker to predict the change of the expression of AQP2 in congenital HNK tissue,thus it may provide evidence for evaluating the urinary concentrating capacity.