CAJ | 학술논문

目的研究尿足细胞与狼疮肾炎（ LN）的关系，探讨尿足细胞评估 LN 肾损伤的临床价值。方法选取20例行肾活检的LN患者，收集相关临床资料，光镜观察肾组织病理改变；电镜观察足细胞超微结构变化；免疫组化检测肾足细胞蛋白 Nephrin 的表达；免疫荧光技术检测 Podocalyxin 表达来计数尿足细胞数量。结果20例LN病理显示Ⅲ型2例、Ⅳ型12例、Ⅳ型＋Ⅴ型4例、Ⅴ型2例，足细胞标志蛋白Nephrin 表达较正常组明显减低，且Ⅳ型、Ⅴ型降低更明显。尿足细胞阳性检出率约80％，尿足细胞数量与肾<br>　　足细胞相关蛋白 Nephrin 的表达呈负相关（r＝－0．627， P ＜0．01），与狼疮活动性呈正相关（r＝0．571， P ＜0．05），与24h蛋白定量无明显相关性（r＝0．215， P ＞0．05）。结论尿足细胞数量可监测狼疮活动及肾小球损伤程度，为LN病理分型提供参考。
목적연구뇨족세포여랑창신염（ LN）적관계，탐토뇨족세포평고 LN 신손상적림상개치。방법선취20례행신활검적LN환자，수집상관림상자료，광경관찰신조직병리개변；전경관찰족세포초미결구변화；면역조화검측신족세포단백 Nephrin 적표체；면역형광기술검측 Podocalyxin 표체래계수뇨족세포수량。결과20례LN병리현시Ⅲ형2례、Ⅳ형12례、Ⅳ형＋Ⅴ형4례、Ⅴ형2례，족세포표지단백Nephrin 표체교정상조명현감저，차Ⅳ형、Ⅴ형강저경명현。뇨족세포양성검출솔약80％，뇨족세포수량여신<br>　　족세포상관단백 Nephrin 적표체정부상관（r＝－0．627， P ＜0．01），여랑창활동성정정상관（r＝0．571， P ＜0．05），여24h단백정량무명현상관성（r＝0．215， P ＞0．05）。결론뇨족세포수량가감측랑창활동급신소구손상정도，위LN병리분형제공삼고。
Objectives To study the relationship of urinary podocytes with lupus nephritis (LN), and to investigate the clinical value of urinary podocyte as a marker of kidney injury in lupus nephritis .Methods Clini-cal dates were collected in the kidney biopsy of 20 patients with lupus nephritis.Renal histomorphology was observed by optic microscope and transmission electron microscope.The expression of nephrin protein was examined by immu-nohistochemistry.Urinary podocytes were identified and quantitated by immunofluorescence staining of urinary sedi-ments labeled by monoclonal antibody podocalyxin.Results Renal pathological findings of the patients could be classified into class Ⅲ (n=2), classⅣ (n=12), classⅣ+Ⅴ (n=4), class Ⅴ (n=2).Nephrin protein lev-els were substantially lower than in the normal group, and in class Ⅳ, ⅤLN dreased obvious.80% of the patients had urinary podocytes.The number of urinary podocytes was negatively correlated with nephrin expression in glomer-ular (r=-0.627, P <0.01), glomerular pathological activity index(r=0.571, P <0.05) and no significant cor-relation with 24h protein excretion(r=0.215, P >0.05).Conclusions The use of technology for detecting uri-nary podocytes may be markers of the severity of lupus nephritis and the activity , and protive reference for LN patho-logical class.