中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2012年
12期
922-926
,共5页
蔡敏超%袁伟杰%朱楠%尚明花
蔡敏超%袁偉傑%硃楠%尚明花
채민초%원위걸%주남%상명화
肾疾病%甲状旁腺激素%炎症%早期慢性肾脏病
腎疾病%甲狀徬腺激素%炎癥%早期慢性腎髒病
신질병%갑상방선격소%염증%조기만성신장병
Kidney disease%Parathyroid hormone%Inflammation%Early stage chronic kidney disease
目的 探讨早期慢性肾脏病(CKD)患者肾组织甲状旁腺激素(PTH)表达和分布,以及其在CKD进展中的可能作用.方法 选取2009年至2012年间本科收治并经肾活检确诊的CKD 1期及2期的肾小球肾炎患者82例为研究对象.另取8例肾移植配型不符或肾肿瘤患者的正常肾组织作对照.受试者均检测Scr、BUN、血钙、磷、PTH及25(OH) VitD3等.以Cockcroft-Gault (CG)公式计算肌酐清除率(Ccr),双血浆99mTc-DTPA清除率法检测GFR.根据肾间质炎性细胞浸润程度,将患者分为轻、中、重组,用免疫组化方法观察肾组织PTH表达和分布；用Image-Pro Plus图像分析软件计算各例肾组织PTH阳性染色吸光度(A)值,并比较PTH表达强度差异.结果CKD1期及2期的肾小球肾炎患者的外周血钙、磷、25(OH) VitD3及PTH水平均处于正常范围,PTH与上述其他指标间无相关.不同病理类型肾小球肾炎患者肾组织均可见PTH表达,主要位于肾小管,而肾小球及肾间质也有少量分布,其表达强度均显著高于对照组(P＜0.01),且随肾间质炎性细胞浸润增多,PTH表达增强.各病理类型间肾组织PTH表达强度差异无统计学意义.结论 早期CKD(1期及2期)患者肾组织PTH表达增强,且早于外周血PTH的改变及矿物质和骨代谢紊乱,可能与局部炎性反应程度相关.
目的 探討早期慢性腎髒病(CKD)患者腎組織甲狀徬腺激素(PTH)錶達和分佈,以及其在CKD進展中的可能作用.方法 選取2009年至2012年間本科收治併經腎活檢確診的CKD 1期及2期的腎小毬腎炎患者82例為研究對象.另取8例腎移植配型不符或腎腫瘤患者的正常腎組織作對照.受試者均檢測Scr、BUN、血鈣、燐、PTH及25(OH) VitD3等.以Cockcroft-Gault (CG)公式計算肌酐清除率(Ccr),雙血漿99mTc-DTPA清除率法檢測GFR.根據腎間質炎性細胞浸潤程度,將患者分為輕、中、重組,用免疫組化方法觀察腎組織PTH錶達和分佈；用Image-Pro Plus圖像分析軟件計算各例腎組織PTH暘性染色吸光度(A)值,併比較PTH錶達彊度差異.結果CKD1期及2期的腎小毬腎炎患者的外週血鈣、燐、25(OH) VitD3及PTH水平均處于正常範圍,PTH與上述其他指標間無相關.不同病理類型腎小毬腎炎患者腎組織均可見PTH錶達,主要位于腎小管,而腎小毬及腎間質也有少量分佈,其錶達彊度均顯著高于對照組(P＜0.01),且隨腎間質炎性細胞浸潤增多,PTH錶達增彊.各病理類型間腎組織PTH錶達彊度差異無統計學意義.結論 早期CKD(1期及2期)患者腎組織PTH錶達增彊,且早于外週血PTH的改變及礦物質和骨代謝紊亂,可能與跼部炎性反應程度相關.
목적 탐토조기만성신장병(CKD)환자신조직갑상방선격소(PTH)표체화분포,이급기재CKD진전중적가능작용.방법 선취2009년지2012년간본과수치병경신활검학진적CKD 1기급2기적신소구신염환자82례위연구대상.령취8례신이식배형불부혹신종류환자적정상신조직작대조.수시자균검측Scr、BUN、혈개、린、PTH급25(OH) VitD3등.이Cockcroft-Gault (CG)공식계산기항청제솔(Ccr),쌍혈장99mTc-DTPA청제솔법검측GFR.근거신간질염성세포침윤정도,장환자분위경、중、중조,용면역조화방법관찰신조직PTH표체화분포；용Image-Pro Plus도상분석연건계산각례신조직PTH양성염색흡광도(A)치,병비교PTH표체강도차이.결과CKD1기급2기적신소구신염환자적외주혈개、린、25(OH) VitD3급PTH수평균처우정상범위,PTH여상술기타지표간무상관.불동병리류형신소구신염환자신조직균가견PTH표체,주요위우신소관,이신소구급신간질야유소량분포,기표체강도균현저고우대조조(P＜0.01),차수신간질염성세포침윤증다,PTH표체증강.각병리류형간신조직PTH표체강도차이무통계학의의.결론 조기CKD(1기급2기)환자신조직PTH표체증강,차조우외주혈PTH적개변급광물질화골대사문란,가능여국부염성반응정도상관.
Objective To investigate the expression and distribution of parathyroid hormone (PTH) in renal tissues of early stage chronic kidney disease (CKD),and to elucidate its potential role in renal lesion.Methods Eighty-two patients of early stage CKD (stage 1 and 2) diagnosed as glomerulonephritis (GN) with different pathologic types by renal biopsy in our department between 2009 and 2012 were enrolled in the study.Renal tissues of eight patients with mismatched HLA haplotype or the normal part of renal cancer were chosen as controls.Scr,BUN,serum calcium,phosphorus,PTH and 25(OH)VitD3 were measured.Creatinine clearance (Ccr) was calculated by Cockcroft-Gault (CG)formula.99mTc-DTPA clearance rate was used to detect GFR.Patients were divided into mild,moderate and severe groups according to the renal interstitial extent of inflammatory cells infiltration.Immunohistochemistry was used to observe the expression and distribution of PTH in renal tissues.Image-Pro Plus software was used to calculate A value of PTH in renal tissues and compare the extent of PTH expression.Results The levels of calcium,phosphorus,25(OH)VitD3 and PTH in peripheral blood from GN patients of CKD stage Ⅰ and 2 were normal.PTH had no correlation with the above indexes.PTH expression could be seen in renal tissues of all the GN patients with different pathologic types,and it mainly located in renal tubular,only a few in glomeruli and interstitium.The expression of PTH in renal tissues of GN increased compared with the controls (P ＜ 0.01).Furthermore,PTH expression elevated with the increase of inflammatory cells infiltration in interstitium.However the expression of PTH was not significantly different among different pathologic types of GN.Conclusions In the early stage CKD,PTH expression in patients of GN increases,which occurs earlier as compared to PTH elevation in peripheral blood and the imbalance of minerals and bone metabolism.The intensity of PTH expression is associated with the local inflammation.
