TGF-β1在儿童原发性IgA肾病肾损害中的临床意义

Clinical significance of TGF-β1 in children with primary IgA nephropathy

摘要:

目的 探讨转化生长因子-β1（TGF-βl）在儿童原发性IgA 肾病（IgAN）患儿肾损害中的临床意义。方法 选择2008 年5 月至2012 年10 月间经肾活检诊断为原发性IgAN 的30 例儿童为研究对象，另30例健康儿童作为对照组。采用酶联免疫吸附实验（ELISA）法检测其血和尿中TGF-β1 的浓度，免疫组织化学法检查肾组织中 TGF-β1 蛋白的表达，并进行血、尿和肾组织中的 TGF-β1 三者之间及其与各临床指标间的相关性分析。结果 原发性 IgAN 患儿血、尿的 TGF-β1 均高于对照组，差异有统计学意义（P<0.01）。尿的TGF-β1 的表达与肾组织病理分级的严重性有关（r=0.557，P=0.001）；肾脏组织中 TGF-β1 的表达与肾组织病理分级密切相关，且随着其病理分级的增加而增加（r=0.682，P<0.01），血液中 TGF-β1 与肾脏组织中TGF-β1 的表达不相关（r=0.038， P=0.844）。结论 IgAN 患儿尿TGF-β1 的值与IgAN 病理分级的严重程度相关，临床检测尿TGF-β1 可能对评定慢性肾病进展及判断预后有重要的实用价值。

Abstract:

Objective To investigate the clinical significance of transforming growth factor-beta 1 (TGF-β1) in children with primary IgA nephropathy (IgAN). Methods Thirty children who were diagnosed with primary IgAN by renal biopsy between May 2008 and October 2012 were included in the study. Thirty healthy children were used as the control group. Urinary and blood TGF-β1 levels were measured using enzyme-linked immunosorbent assay, and the protein expression of TGF-β1 in the renal tissue was measured by immunohistochemistry. The correlation between TGF-β1 levels in blood, urine, and renal tissue and their relationship with clinical indices were analyzed. Results Children with primary IgAN had significantly higher urinary and blood TGF-β1 levels than the control group (P<0.01). Urinary TGF-β1 level was positively correlated with the pathological grade of renal tissue (r=0.557, P=0.001), and a significant positive correlation was also found between the TGF-β1 expression in the renal tissue and the pathological grade of renal tissue (r=0.682, P<0.01). There was no correlation between TGF-β1 levels in blood and renal tissue (r=0.038, P=0.844). Conclusions Urinary TGF-β1 level is significantly positively correlated with the pathological severity of disease in children with primary IgAN. Clinical measurement of urinary TGF-β1 may be of great practical value in predicting the progression and prognosis of chronic nephropathy.