CAJ | 학술논문

目的：探讨IgA肾病患者尿蛋白和血管内皮生长因子（VEGF）的相关性。方法收集新乡医学院第三附属医院经肾活检确诊的67例IgA肾病患者的资料，采用免疫组织化学法检测肾组织VEGF的表达情况，酶联免疫吸附法分别检测血和尿VEGF水平并分析三者在不同病理参数的分布情况，采用直线回归分析尿蛋白与VEGF的相关性，分析不同尿蛋白和 VEGF组合的生化指标和治疗效果。结果（1）IgA肾病组的尿和血VEGF水平高于健康对照组和狼疮性肾炎组，肾组织VEGF表达高于狼疮性肾炎组（P＜0．01）；且IgA肾病组的VEGF水平在Lee氏分级、肾小管间质损伤和Katafuchi总积分方面差异有统计学意义（P＜0．05），且随着病理严重程度的增加而升高；（2）IgA肾病不同程度尿蛋白患者的肾组织VEGF表达、尿和血VEGF水平差异有统计学意义，且依据尿蛋白小于1．0g、1．0～3．0g和大于3．0g的顺序递增（P＜0．05），尿蛋白水平与肾组织VEGF表达、尿和血VEGF呈正相关（r＝0．59，P＜0．01；r＝0．46，P＜0．01；r＝0．37，P＜0．05）；（3）IgA 肾病同一尿蛋白水平不同的V EG F水平间的血清清蛋白、血Ig A、肌酐、肾小球滤过率、尿β2-微球蛋白、尿渗透压、血尿素氮和治疗显效率差异有统计学意义（P＜0．05）。结论 IgA肾病患者肾脏组织的VEGF表达增强、血和尿VEGF水平升高，均与尿蛋白呈正相关，且不同尿蛋白和V EG F组合的病理指标和治疗效果上差异有统计学意义。
목적：탐토IgA신병환자뇨단백화혈관내피생장인자（VEGF）적상관성。방법수집신향의학원제삼부속의원경신활검학진적67례IgA신병환자적자료，채용면역조직화학법검측신조직VEGF적표체정황，매련면역흡부법분별검측혈화뇨VEGF수평병분석삼자재불동병리삼수적분포정황，채용직선회귀분석뇨단백여VEGF적상관성，분석불동뇨단백화 VEGF조합적생화지표화치료효과。결과（1）IgA신병조적뇨화혈VEGF수평고우건강대조조화랑창성신염조，신조직VEGF표체고우랑창성신염조（P＜0．01）；차IgA신병조적VEGF수평재Lee씨분급、신소관간질손상화Katafuchi총적분방면차이유통계학의의（P＜0．05），차수착병리엄중정도적증가이승고；（2）IgA신병불동정도뇨단백환자적신조직VEGF표체、뇨화혈VEGF수평차이유통계학의의，차의거뇨단백소우1．0g、1．0～3．0g화대우3．0g적순서체증（P＜0．05），뇨단백수평여신조직VEGF표체、뇨화혈VEGF정정상관（r＝0．59，P＜0．01；r＝0．46，P＜0．01；r＝0．37，P＜0．05）；（3）IgA 신병동일뇨단백수평불동적V EG F수평간적혈청청단백、혈Ig A、기항、신소구려과솔、뇨β2-미구단백、뇨삼투압、혈뇨소담화치료현효솔차이유통계학의의（P＜0．05）。결론 IgA신병환자신장조직적VEGF표체증강、혈화뇨VEGF수평승고，균여뇨단백정정상관，차불동뇨단백화V EG F조합적병리지표화치료효과상차이유통계학의의。
Objective To investigate the correlation between urine protein and VEGF in of IgA nephropathy patients .Methods Selected data of 67 patients of IgA nephropathy patients in Xinxiang Medical University ,VEGF expression was tested by immuno-histochemistry in renal tissue ,enzyme linked immunosorbent assay were used to detect the serum and urine levels of VEGF and ana-lyze the distribution of different pathological parameters .Analyzed correlation between urine protein and VEGF by regression analy-sis ,and analyzed the therapeutic effect and biochemical index in different combination of urinary protein and VEGF .Results (1)u-rine and serum VEGF levels in patients with IgA nephropathy were higher than healthy controls and patients with lupus nephritis group ,expression of VEGF in renal tissue was higher than that of lupus nephritis group (P<0 .01) ,and the difference of VEGF lev-el of IgA nephropathy group in Lee's classification ,renal tubular interstitial lesions and Katafuchi total score had statistically signifi-cant(P<0 .05) ,and increased with the severity of the pathological ;(2)Renal tissue VEGF urine and blood VEGF level were statis-tically significant in different levels of urinary protein of IgA nephropathy ,and increased according to urine protein was less than 1 .0 g ,1 .0 to 3 .0 g and more than 3 .0 g(P<0 .05) .Levels of urinary protein and VEGF expression in the kidney ,urinary VEGF and serum VEGF levels were positively correlated (r=0 .59 ,P<0 .01 ;r=0 .46 ,P<0 .01;r=0 .37 ,P<0 .05);(3) IgA nephropathy with urinary protein level between different levels of VEGF sAlb ,blood IgA ,Cr ,eGFR ,β2-MG ,urine osmotic pressure ,BUN and the effect rate of treatment differences were statistically significant (P<0 .05) .Conclusion Renal tissue VEGF expression in pa-tients with IgA nephropathy enhance ,while levels of VEGF in blood and urine were increased and associated with urinary protein . Pathological factors and treatment effect have statistically significant difference between different urinary protein and VEGF combi-nation .