Shen Peicheng, Shen Jiaojiao, Li Wenwen, He Liqun
Clin Lab. 2014;60(10):1709-15. doi: 10.7754/clin.lab.2014.131225.
To evaluate the clinical significance of the urinary podocytes in patients with IgA nephropathy.
Urine samples from 102 biopsy-confirmed IgA nephropathy patients were collected to detect urinary podocytes using an indirect immunofluorescence staining method with anti-human Podocalyxin (PCX) antibody. Then, correlation analysis was performed between the urinary podocyte counts and the clinicopathological changes.
Upon comparison with IgA nephropathy patients with negative urinary podocytes, IgA nephropathy patients with positive urinary podocytes presented a significant reduction in plasma albumin and glomerular filtration rate and remarkable rise in urinary protein excretion, blood cholesterol, and mean arterial pressure. Pathologically, the renal tissues of IgA nephropathy patients with positive urinary podocytes presented less podocytes in the glomerulus (6.03 ± 3.61 cells/glomerulus vs. 12.58 ± 7.23 cells/glomerulus, p < 0.001), more mesangial matrix, and more aggravated interstitial fibrosis and foot process fusion than in IgA nephropathy patients with negative urinary podocytes. In addition, the urinary podocyte counts were positively correlated with serum creatinine and 24-hour urinary protein excretion (r = 0.332, p < 0.05 and r = 0.387, p < 0.05, respectively) and negatively correlated with the number of podocytes in the renal tissues (r = -0.416, p 0 < 0.05).
Detection of urinary podocytes can be a noninvasive indicator for reflecting the severity of IgA nephropathy.
评估IgA肾病患者尿足细胞的临床意义。
收集102例经活检确诊的IgA肾病患者的尿液样本,采用抗人足细胞标记蛋白(PCX)抗体间接免疫荧光染色法检测尿足细胞。然后,对尿足细胞计数与临床病理变化进行相关性分析。
与尿足细胞阴性的IgA肾病患者相比,尿足细胞阳性的IgA肾病患者血浆白蛋白和肾小球滤过率显著降低,尿蛋白排泄、血胆固醇和平均动脉压显著升高。病理上,尿足细胞阳性的IgA肾病患者肾组织肾小球中的足细胞较少(6.03±3.61个/肾小球 vs. 12.58±7.23个/肾小球,p<0.001),系膜基质更多,间质纤维化和足突融合比尿足细胞阴性的IgA肾病患者更严重。此外,尿足细胞计数与血清肌酐和24小时尿蛋白排泄呈正相关(r=0.332,p<0.05和r=0.387,p<0.05),与肾组织中足细胞数量呈负相关(r=-0.416,p<0.05)。
检测尿足细胞可作为反映IgA肾病严重程度的无创指标。