中南大学学报（医学版）
中南大學學報（醫學版）
중남대학학보（의학판）
JOURNAL OF CENTRAL SOUTH UNIVERSITY (MEDICAL SCIENCES)
2009年
12期
1209-1215
,共7页
彭仕友%何小解%易著文%党西强
彭仕友%何小解%易著文%黨西彊
팽사우%하소해%역저문%당서강
过敏性紫癜%肾炎%微血管%血管内皮生长因子%儿童
過敏性紫癜%腎炎%微血管%血管內皮生長因子%兒童
과민성자전%신염%미혈관%혈관내피생장인자%인동
Henoch Schonlein purpura%nephritis%microvessel%vascular endothelial growth factor%children
目的:探讨过敏性紫癜性肾炎(Henoch Schonlein purpura nephritis,HSPN)患儿尿中血管内皮生长因子(vascular endothelial growth factor,VEGF)浓度与肾脏血管损害的关系.方法:对肾穿刺活检确诊的78例HSPN患儿按肾血管损害、肾小球病理损害、肾小管间质病理损害进行半定量积分,肾小球、肾小管间质、血管病理积分及肾小球与肾小管间质总病理积分各分为轻、中、重3组;酶联免疫吸附法检测其血、尿中VEGF浓度;免疫组织化学法检测肾局部VEGF表达及肾脏微血管密度.结果:肾小球、肾小管间质、血管病理积分及肾小球与肾小管间质总病理积分轻、中、重组之间差异有统计学意义(均P＜0.01);肾脏血管损害愈轻,微血管密度、血与肾局部中VEGF浓度则愈高,而尿中VEGF排泄也愈低,轻、中、重组3组之间差异有统计学意义(均P＜0.01).肾小球积分与肾小管间质积分、血管积分、肾脏总积分相互呈高度正相关(r=0.596,0.612,0.728,分别P<0.05,0.05,0.01),微血管密度与血VEGF和肾VEGF相互呈高度正相关,与尿中VEGF呈高度负相关(r=0.601,0.696,-0.639,均P＜0.01).结论:尿中VEGF排泄增加使肾局部VEGF浓度下降进而导致的肾血管损伤,可能是HSPN患儿肾血管损害与病理慢性进展的重要原因.
目的:探討過敏性紫癜性腎炎(Henoch Schonlein purpura nephritis,HSPN)患兒尿中血管內皮生長因子(vascular endothelial growth factor,VEGF)濃度與腎髒血管損害的關繫.方法:對腎穿刺活檢確診的78例HSPN患兒按腎血管損害、腎小毬病理損害、腎小管間質病理損害進行半定量積分,腎小毬、腎小管間質、血管病理積分及腎小毬與腎小管間質總病理積分各分為輕、中、重3組;酶聯免疫吸附法檢測其血、尿中VEGF濃度;免疫組織化學法檢測腎跼部VEGF錶達及腎髒微血管密度.結果:腎小毬、腎小管間質、血管病理積分及腎小毬與腎小管間質總病理積分輕、中、重組之間差異有統計學意義(均P＜0.01);腎髒血管損害愈輕,微血管密度、血與腎跼部中VEGF濃度則愈高,而尿中VEGF排洩也愈低,輕、中、重組3組之間差異有統計學意義(均P＜0.01).腎小毬積分與腎小管間質積分、血管積分、腎髒總積分相互呈高度正相關(r=0.596,0.612,0.728,分彆P<0.05,0.05,0.01),微血管密度與血VEGF和腎VEGF相互呈高度正相關,與尿中VEGF呈高度負相關(r=0.601,0.696,-0.639,均P＜0.01).結論:尿中VEGF排洩增加使腎跼部VEGF濃度下降進而導緻的腎血管損傷,可能是HSPN患兒腎血管損害與病理慢性進展的重要原因.
목적:탐토과민성자전성신염(Henoch Schonlein purpura nephritis,HSPN)환인뇨중혈관내피생장인자(vascular endothelial growth factor,VEGF)농도여신장혈관손해적관계.방법:대신천자활검학진적78례HSPN환인안신혈관손해、신소구병리손해、신소관간질병리손해진행반정량적분,신소구、신소관간질、혈관병리적분급신소구여신소관간질총병리적분각분위경、중、중3조;매련면역흡부법검측기혈、뇨중VEGF농도;면역조직화학법검측신국부VEGF표체급신장미혈관밀도.결과:신소구、신소관간질、혈관병리적분급신소구여신소관간질총병리적분경、중、중조지간차이유통계학의의(균P＜0.01);신장혈관손해유경,미혈관밀도、혈여신국부중VEGF농도칙유고,이뇨중VEGF배설야유저,경、중、중조3조지간차이유통계학의의(균P＜0.01).신소구적분여신소관간질적분、혈관적분、신장총적분상호정고도정상관(r=0.596,0.612,0.728,분별P<0.05,0.05,0.01),미혈관밀도여혈VEGF화신VEGF상호정고도정상관,여뇨중VEGF정고도부상관(r=0.601,0.696,-0.639,균P＜0.01).결론:뇨중VEGF배설증가사신국부VEGF농도하강진이도치적신혈관손상,가능시HSPN환인신혈관손해여병리만성진전적중요원인.
Objective To explore the relationship between vascular endothelial growth factor (VEGF) concentration in urine and renal vascular damage in children with Henoch Schonlein purpura nephritis (HSPN).Methods The kidney pathological lesion of 78 biopsy-proven HSPN children was assessed with renal vascular damage, glomerular pathological damage, and tubulointerstitial pathological damage semi-quantitative points. The children were divided into 3 groups (light, medium, and heavy group) according to the renal vascular, glomerular, tubulointerstitial, glomerular and tubulointerstitial total pathological points. Blood and urine vascular endothelial growth factor concentration was detected by enzyme linked immunosorbent assay;the localized renal VEGF expression and microvessel density were detected by immunohistochemistry assay in the kidneys. Results The semi-quantitative points of glomerular, tubulointerstitial, renal vascular, and glomerular and tubulointerstitial total points in different groups had significant difference (all P＜0.01);the minor renal vascular damage, the higher light microvessel density, blood and kidney concentration of VEGF, and the VEGF excretion in the urine were also lower in different groups, and there were significant differences (all P＜0.01). Glomerular points were positively related with tubular points, vascular points, kidney total score (r=0.596,0.612, and 0.728;P＜0.05, 0.05, and 0.01 respectively). Microvessel density was highly positively related with blood VEGF and renal VEGF, and negatively rela-ted with urine VEGF (r=0.601, 0.696, and -0.639,all P＜0.01). Conclusion The urinary excretion of VEGF leads to the decrease of local kidney VEGF concentration resulting in the renal vascular injury, which may be the important reason for renal vascular damage and pathology chronic progress in HSPN children.
