中文摘要：

目的：观察糖尿病肾病（DN）患者肾活检组织血管紧张素受体表达情况,并探讨与肾小球及肾间质病理损伤程度的关系。方法：选取2004年1月～2014年9月在中日友好医院肾内科行肾穿刺活检并经临床及病理诊断为DN的患者90例,其中病理分型为Ⅰ型＋Ⅱa型14例,Ⅱb型13例,Ⅲ型58例,Ⅳ型5例。使用免疫组化染色分析累积光密度评估肾组织中AT1、AT2及MAS受体表达情况。比较各型患者的临床资料、肾脏AT1、AT2及MAS受体表达,并评估后者与其他肾小球损伤病理指标（缺血肾小球百分比、球性硬化肾小球百分比及新月体百分比）和肾间质损伤病理指标（肾间质纤维化肾小管萎缩评分、肾间质炎症评分及小动脉玻璃样变评分）之间的相关性。结果：肾小球AT1受体表达与缺血肾小球百分比和球性硬化肾小球百分比均存在显著正相关。病理分型为Ⅲ型的患者肾小球和肾间质的AT2受体表达均显著高于Ⅱb型患者,且肾小球AT2受体表达与缺血肾小球百分比呈现显著正相关。结论：DN患者肾组织血管紧张素受体表达与肾脏病理改变存在一定的相关性,为深入了解RAS在DN病理损伤过程的作用提供了依据。

英文摘要：

Objective： To observe the expression of angiotensin receptors in kidney of diabetic nephropathy（ DN） patients,and to discuss its relationship with renal pathological damage. Methods： 90 patients diagnosed as DN by renal biopsy from the Department of Nephrology of China- Japan Friendship Hospital from January,2004 to September,2014 were enrolled in our research（ 14 cases of classⅠ ＋ Ⅱa,13 cases of class Ⅱb,58 cases of classⅢ and 5 cases of class Ⅳ）. The expression of angiotensin receptors of AT1,AT2 and MAS was evaluated by immunohistochemistry and analyzed by integrated optical density（ IOD）. Clinical data,protein expression of AT1,AT2 and MAS receptors and their relation with glomerular or interstitial pathological injury were evaluated.Results： Glomerular AT1 receptor expression showed significant positive correlation with percentage of glomeruli with ischemic lesion and percentage of glomeruli sclerosis,respectively. Glomerular and interstitial AT2 receptor expression in patients of class Ⅲ was significantly stronger than class Ⅱb. Positive correlation showed between glomerular AT2 receptor expression and percentage of glomeruli with ischemic lesion. Conclusion： Renal angiotensin receptors expression was associated with pathologic injury in DN patients,which provided more evidence to elucidate the role of RAS in DN.