CAJ | 학술논문

目的研究IgA肾病(Ig A nephropathy,IgAN)患者血液中穿通支原体(mycoplasma penetrans,Mpe)、肺炎支原体(mycoplasma pneumoniae,Mp)和发酵支原体(mycoplasma ferments,Mf)的检出率,IgA肾病、慢性肾脏病(chronic kidney disease,CKD)患者和健康体检者血液中支原体检出率之间的差异及与临床特点的关系.方法采集经病理检查确诊为IgAN患者的血液标本118例,健康体检者89例,CKD对照组90例.按试剂盒方法提取血清DNA,用PCR技术检测Mpe、Mp及Mf特异性基因片段,阳性标本采用Southern blot方法进行证实.根据IgAN患者支原体感染情况进行分组,结合患者的临床病理资料进行分析.结果 (1)IgAN组中Genus、Mpe、Mp、Mf感染阳性率分别为33.05％、16.1％、25.45％和8.47％.CKD疾病对照组中Genus、Mpe、Mp、Mf阳性率分别5.56％、2.22％、5.56％和2.22％.健康对照组中Genus、Mpe、Mp、Mf阳性率分别为3.33％、1.11％、2.22％和0.IgAN组与CKD、健康体检者Genus、Mpe及Mp阳性率相比差异有统计学意义(P＜0.05).IgAN组中10例同时检测到Mpe、Mp和Mf(多重感染检出率8.47％),CKD组2例(多重感染率为 2.22％),两组比较差异有统计学意义(P＜0.05).(2)10例存在重叠感染的IgAN发病年纪较轻,扁桃体炎和尿路感染病史,镜下红细胞检测及肾间质病理积分比较,多重支原体感染组患者明显重于支原体阴性组,差异有统计学意义(P＜0.05).结论 IgAN中Genus、Mpe及Mp的检出率显著高于健康体检者和CKD患者,存在多重支原体感染的IgAN患者肾间质病理改变较重,本研究提示IgAN的发病或进展可能与支原体感染有关.
목적 연구IgA신병(Ig A nephropathy,IgAN)환자혈액중천통지원체(mycoplasma penetrans,Mpe)、폐염지원체(mycoplasma pneumoniae,Mp)화발효지원체(mycoplasma ferments,Mf)적검출솔,IgA신병、만성신장병(chronic kidney disease,CKD)환자화건강체검자혈액중지원체검출솔지간적차이급여림상특점적관계.방법 채집경병리검사학진위IgAN환자적혈액표본118례,건강체검자89례,CKD대조조90례.안시제합방법제취혈청DNA,용PCR기술검측Mpe、Mp급Mf특이성기인편단,양성표본채용Southern blot방법진행증실.근거IgAN환자지원체감염정황진행분조,결합환자적림상병리자료진행분석.결과 (1)IgAN조중Genus、Mpe、Mp、Mf감염양성솔분별위33.05％、16.1％、25.45％화8.47％.CKD질병대조조중Genus、Mpe、Mp、Mf양성솔분별5.56％、2.22％、5.56％화2.22％.건강대조조중Genus、Mpe、Mp、Mf양성솔분별위3.33％、1.11％、2.22％화0.IgAN조여CKD、건강체검자Genus、Mpe급Mp양성솔상비차이유통계학의의(P＜0.05).IgAN조중10례동시검측도Mpe、Mp화Mf(다중감염검출솔8.47％),CKD조2례(다중감염솔위 2.22％),량조비교차이유통계학의의(P＜0.05).(2)10례존재중첩감염적IgAN발병년기교경,편도체염화뇨로감염병사,경하홍세포검측급신간질병리적분비교,다중지원체감염조환자명현중우지원체음성조,차이유통계학의의(P＜0.05).결론 IgAN중Genus、Mpe급Mp적검출솔현저고우건강체검자화CKD환자,존재다중지원체감염적IgAN환자신간질병리개변교중,본연구제시IgAN적발병혹진전가능여지원체감염유관.
Objective To investigate the infection rates of mycoplasma penetrans (Mpe),mycoplasma pneumoniae (Mp) and mycoplasma ferments (Mf) in patients with IgA nephropathy (IgAN),chronic kideny disease (CKD),and heathy people,to compare the difference of infection rate,and to analyze the association of mycoplasma infection and clinicopathological features in IgAN.Methods Blood samples were collected from 118 patients in IgAN group,90 patients in CKD group,and 89 cases in health control group.DNA of Mpe,Mp and Mf was detected in plasma by PCR.Positive cases were confirmed by Southern blot.According to mycoplasma infection,IgAN patients were divided into two groups,then analyzed the clinicopatholgical features.Results (1)Genus,Mpe,Mp,and Mf positive rates were 33.05％,16.1％,25.45 ％,and 8.47％ in IgAN group,respectively; 5.56％,2.22％,5.56％,and 2.22％ in CKD group,respectively; and 3.33 ％,1.11％,2.22％,and 0 in health group,respectively.Compared with CKD and health group,patients in IgAN group had a higher infection rate in Genus,Mpe,and Mp (P ＜ 0.05).In IgAN group,10 patients had three kinds of mycoplasmas infection at the same time,and positive rate was 8.47％ much higher than CKD group (positive rate was 2.22％) (P ＜ 0.05).(2) Based on mycoplasm detection results,IgAN patients were divided into two groups,overlapping infection group and mycoplasma negative group.In overlapping infection group,the mean age of onset was much younger than negative group.Compared with negative group,overlapping infection group had higher tonsillitis and urinary tract infection rate,more severe microscopic hematuria and tubulointerstitium lesion (P ＜ 0.05).Conclusions Patients with IgAN had higher infection rate of Genus,Mpe and Mp,compared with CKD patients and health people.Compared with mycoplasma negative group in IgAN patients,more severe microscopic hematuria and tubulointerstitium lesion in overlapping infection group,which suggested that infection of Mpe might have some possible connection with IgAN.