肺炎衣原体持续感染与原发性IgA肾病相关

[Chlamydia pneumoniae persistent infection is associated with primary IgA nephropathy].

作者信息

Zhao Dean, Zhao Ying, Yang Dasheng

机构信息

Department of Pediatrics, First Affiliated Hospital, Xinxiang Medical University, Weihui 453100, China.

Department of Pharmacology, Xinxiang Medical University, Xinxiang 453003, China.

出版信息

Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi. 2014 Jul;30(7):754-8.

PMID:25001944

Abstract

OBJECTIVE

To explore the correlations between Chlamydia pneumoniae (CP) infection and IgA nephropathy (IgAN).

METHODS

Seventy patients with primary IgAN were enrolled in the study. Seventy serum specimens from healthy blood donors and twelve renal autopsy specimens from accidental death bodies were regarded as control groups. Serum CP IgG and CP IgA antibody titers were detected by indirect immunofluorescence. CP DNA of renal tissue was measured by fluorescent quantitative PCR. Finally, using statistical methods, we analyzed the correlations of CP infection and CP DNA of renal tissue with clinical manifestations and kidney pathological changes of IgAN patients.

RESULTS

The rate of CP persistent infection in IgAN group was higher than that of healthy blood donor group (P<0.01). The rate was not significantly different within the IgAN group, such as among acute infection, previous infection and no infection subgroups (P>0.05). It was higher in the patients with gross proteinuria and/or durative renal insufficiency than in non-gross proteinuria patients (P<0.05). The scores of glomerular patholopical and tubulointerstitial injury of CP persistent infection patients were higher than those of non-persistent infection ones (P<0.05). The renal injury of CP persistent infection patients was more severe than that of non-persistent infection ones. The positive rate of CP DNA in gross proteinuria and/or renal insufficiency patients was higher than that of non-gross proteinuria patients (P<0.05). The scores of glomerular pathological and tubulointerstitial injury of positive CP DNA patients were respectively higher than those of negative CP DNA ones (P<0.05, P<0.01). The renal injury of patients with positive CP DNA was more severe than that of negative CP DNA ones. CP persistent infection was obviously correlated with renal CP DNA (P<0.01).

CONCLUSION

Primary IgAN is associated with CP persistent infection, but not with CP previous infection or CP acute infection.

摘要

目的

探讨肺炎衣原体（CP）感染与IgA肾病（IgAN）之间的相关性。

方法

本研究纳入70例原发性IgAN患者。将70份来自健康献血者的血清标本和12份来自意外死亡尸体的肾脏尸检标本作为对照组。采用间接免疫荧光法检测血清CP IgG和CP IgA抗体滴度。采用荧光定量PCR法检测肾组织中的CP DNA。最后，运用统计学方法分析CP感染及肾组织CP DNA与IgAN患者临床表现及肾脏病理改变的相关性。

结果

IgAN组CP持续感染率高于健康献血者组（P<0.01）。IgAN组内急性感染、既往感染和未感染亚组之间该率无显著差异（P>0.05）。大量蛋白尿和/或持续性肾功能不全患者的该率高于非大量蛋白尿患者（P<0.05）。CP持续感染患者的肾小球病理和肾小管间质损伤评分高于非持续感染患者（P<0.05）。CP持续感染患者的肾损伤比非持续感染患者更严重。大量蛋白尿和/或肾功能不全患者的CP DNA阳性率高于非大量蛋白尿患者（P<0.05）。CP DNA阳性患者的肾小球病理和肾小管间质损伤评分分别高于CP DNA阴性患者（P<0.05，P<0.01）。CP DNA阳性患者的肾损伤比CP DNA阴性患者更严重。CP持续感染与肾组织CP DNA明显相关（P<0.01）。