摘要
目的探究足细胞蛋白Podocalyxin与紫癜性肾炎(HSPN)患儿足细胞损伤、病理分级以及临床分型之间的关联,为更好的开展临床诊断提供参考。方法将郑州大学附属儿童医院自2018年1月至2020年6月间经肾活检最终确诊为HSPN的63例患儿作为临床研究对象,分别针对患儿开展Podocalyxin检测以及肾穿刺活检。通过肾组织病理检验(常规的病理分级、免疫荧光分型及电镜)观察分析肾小球足细胞的损伤程度,从而探讨Podocalyxin对于儿童HSPN的临床诊断意义。结果经过肾脏穿刺活检,共有29例患儿被确诊为Ⅱ级HSPN(46.03%);另有34例患儿被确诊为Ⅲ级HSPN(53.97%)。检验数据表明,Ⅲ级患儿的Podocalyxin显著高于Ⅱ级患儿。以电镜方式观察肾小球足细胞损伤情况分析:18例患者的足突呈现出广泛融合态势,32例患儿呈现出足突的节段融合,9例无足突融合,另外4例患儿在电镜观察下未见肾小球。肾小球足细胞损伤的加重与患儿尿液中Podocalyxin的检测值呈正相关。此外,HSPN患儿尿液中Podocalyxin的检测值与其临床分型具有明显的相关性。结论足细胞Podocalyxin与HSPN患儿的足细胞损伤、病理分级和临床分型之间具有明显的相关性,有望成为HSPN患儿的临床诊断标志物。
Objective To study the relationship between podocyte injury,pathological grading,clinical classification and podocalyxin in children with Henoch-Schonlein purpura nephritis(HSPN),so as to provide a reference for clinical diagnosis.Methods A total of 63 children with HSPN confirmed by renal biopsy in our hospital from January 2018 to June 2020 were selected as the research subject.Podocalyxin detection and renal biopsy were carried out.Pathological examination of renal tissues was performed for conventional pathological grading and immunofluorescence typing to observe and analyze the damage degree of glomerular podocytes,so as to explore the clinical diagnostic significance of Podocalyxin in children with HSPN.Results A total of 29 children were diagnosed with gradeⅡHSPN(46.03%)after renal biopsy.Another 34 children were diagnosed with gradeⅢHSPN(53.97%).The test data showed that the Podocalyxin level in gradeⅲchildren was significantly higher than that in gradeⅱchildren.Analysis of glomerular podoccyte injury observed by electron microscopy:18 patients showed extensive fusion of foot processes,32 children showed segmental fusion of foot processes,9 children showed no fusion of foot processes,and the other 4 children did not see glomerulus under electron microscopy.The aggravation of glomerular podoccyte injury was positively correlated with the detection value of Podocalyxin in urine.In addition,the urine Podocalyxin detection value of HSPN children was significantly correlated with its clinical classification.Conclusion Podocalyxin is significantly correlated with podocyte damage,pathological grade and clinical typing in children with HSPN,and is expected to be a clinical diagnostic marker for children with HSPN.
作者
龙安予
王玉
滑洋洋
LONG Anyu;WANG Yu;HUA Yangyang(Department of Pathology,Children's Hospital Affiliated to Zhengzhou University,Zhengzhou Henan 450000,China)
出处
《临床研究》
2022年第5期136-139,共4页
Clinical Research
