肾间质中单个核细胞浸润与肾脏疾病临床转归的关系

Relationship between mononuclear cells infiltration in renal interstitium and the prognosis of kidney disease

摘要:

目的：肾小管间质病变程度是肾脏疾病预后的决定因素。该实验研究肾间质中单个核细胞的浸润、肾小管间质病变的程度与肾脏疾病临床转归三者关系,探讨肾间质单个核细胞的浸润在肾脏疾病临床转归中的作用。方法：选择1998年2月至2000年9月因各种原发和继发性肾脏疾病而入院行肾穿刺活检术的患儿共42例,肾组织用CD4+,CD8+,CD68+3种单克隆抗体标记淋巴细胞和单核-巨噬细胞,计算CD4+,CD8+,CD68+在肾间质中浸润的密度,用等级相关分析其与肾小管间质病变程度以及与临床转归的关系。结果：肾间质中CD4+,CD8+,CD68+细胞浸润密度与肾小管间质病变程度呈正相关(rs=0.570, P=0.029;rs=0.368,P=0.009,rs=0.468,P=0.003)。肾小管间质病变程度与临床转归之间呈正相关(rs=0.467, P=0. 001 )。肾间质CD8+,CD68+细胞的浸润密度与临床转归之间也呈正相关(rs=0.398,P=0.004;rs=0.328,P=0. 036)。肾间质中单个核细胞浸润的种类数与临床转归正相关(rs=0.453, P=0. 003)。结论：肾间质单个核细胞浸润的密度和种类数与肾脏疾病预后密切相关。肾小管间质单个核细胞浸润可能促进了肾小管间质的病变,使肾脏疾病预后不良。

Abstract:

OBJECTIVE: The degree of renal tubulointerstitial injury determines the prognosis of renal disease. This research studied the relationship among mononuclear cells infiltration, the degree of renal tubulointerstitial injury and the prognosis of renal disease, so as to explore the effect of mononuclear cells infiltration in prognosis of renal disease. METHODS: The renal biopsy specimens from 42 children with primary or secondary kidney disease were studied. Mononuclear cells were detected by CD4+, CD8+ or CD68+ immunohistochemistry. The relationship among the expressions of CD4+, CD8+ and CD68+ in the renal interstitium, renal tubulointerstitial pathological changes and prognosis of renal diseases were analyzed. RESULTS: There were positive correlations between the expressions of CD4+, CD8+ and CD68+ in the renal interstitium and renal tubulointerstitial pathological changes (r_s=0.570,P=0.029;r_s=0.368,P=0.009, r_s=0.468, P=0.003). The renal tubulointerstitial pathological changes were also positively correlated to the prognosis of renal diseases (r_s=0.467, P= 0.001). The expressions of CD8+ and CD68+ in renal interstitium and the prognosis of kidney diseases were correlated (r_s=0.398,P=0.004;r_s=0.328,P=0.036). CONCLUSIONS: There is a close relationship between the density and varieties of infiltrated mononuclear cells in renal interstitium and the prognosis of renal diseases. The mononuclear cells filtration may induce the renal tubulointerstitial fibrosis and result in a poor prognosis of kidney diseases.