乙酰肝素酶和血管内皮生长因子在原发性膜性肾病患者肾小球内的表达及意义(1)
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【摘要】目的：探讨乙酰肝素酶(Heparanase,Hpa)和血管内皮生长因子(VEGF)在原发性膜性肾病(idiopathic membranous nephropathy，IMN)患者肾小球中的表达及与蛋白尿的关系。方法：用免疫组化法检测36例IMN患者与6例正常对照者肾小球内Hpa和VEGF的表达情况。结果：(1)Hpa 和VEGF在对照组正常肾组织的肾小球基底膜及肾小管上皮细胞仅有少量表达。在IMN组肾小球基底膜及肾小管上皮细胞表达较对照组均明显增强(p<0.01)。I期IMN组与II期IMN组比较，肾小球内Hpa的表达差异无显著性(p>0.05)，肾小球内VEGF表达差异有显著性(p<0.01)，II期IMN组较I期IMN组肾小球内VEGF表达减少。(2)Hpa、VEGF和蛋白尿相关性：Hpa与24小时尿蛋白定量呈正相关关系； VEGF与24小时尿蛋白定量呈正相关趋，在I期IMN VEGF与24小时尿蛋白定量呈正相关关系。Hpa与VEGF之间无明显相关性，但在I期IMN二者呈正相关关系。结论： Hpa的异常表达参与IMN的肾病理损害与蛋白尿的形成。 VEGF并非IMN患者肾小球损害与尿蛋白形成的主要参与者。相反，VEGF可能有助于IMN向好的方面转归。 Hpa、VEGF二者之间的作用互相制约。本实验结果可为IMN的治疗策略进一步提供参考，即适当下调Hpa有益于IMN的转归。
【关键词】膜性肾病；乙酰肝素酶；血管内皮生长因子；蛋白尿
【中图分类号】R735.2【文献标识码】A【文章编号】1008-6455(2011)04-0030-03
Clinical significance of expressive change of Hpa and VEGF in glomeruli of idiopathic membranous nephropathy
Yao Suhua1 Wang Yan2 Zhang Yongchang3
【Abstract】Objective: To explore the expression of Hpa and VEGF in glomeruli of patients with idiopathic membranous nephropathy(IMN), and its relationship with albuminuria. Method: Immunohistochemistry was applied to detect the expression of Hpa and VEGF in renal glomerulus of patients with IMN and control group. Results:1 Hpa and VEGF were expressed at a low level in the glomerular basement membrane and the tubular epithelial cells in control group. The expressions of Hpa、VEGF were significantly increased in glomerulus of IMN group(p<0.01). There was no significant difference of the expression of Hpa between I and II stage IMN group(p>0.05). There was significant difference of the expression of VEGF between I and II stage IMN group(p<0.01). Compared with I stage IMN group, the expression of VEGF was reduced in II stageIMN group. 2 The correlation of Hpa 、VEGF with the urine protein quantitation in 24 hours:The expression of Hpa positively correlated with the urine protein quantitation in 24 hours. The expression of VEGF had positively correlated tendency with the urine protein quantitation in 24 hours ......
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