中文摘要：

目的探讨肿瘤坏死因子相关的凋亡诱导配体（tumor necrosis factor related apoptosis inducing ligand,TRAIL）在糖尿病肾病（diabetic nephropathy,DN）患者肾组织的表达以及与肾组织损伤之间的关系。方法选取2010-2013年本科收治的36例患有2型糖尿病经肾活检诊断为DN患者,9例肾错构瘤或肾癌切除术患者经病理检查为正常组织作为对照。收集各组患者人口学资料、临床数据,免疫组织化学检测肾组织TRAIL表达,并与临床数据及肾组织病理损伤进行相关性分析。结果 DN患者TRAIL主要表达于肾小管上皮细胞细胞质和/或细胞膜,其表达水平随着肾小管间质损伤的加重而逐渐增加;与收缩压、尿蛋白定量、尿NAG、尿蛋白/尿肌酐、尿酸、尿素氮、血肌酐、胱抑素C呈正相关（P〈0.05,P〈0.01）,与e GFR呈负相关（r=-0.936,P〈0.01）。结论 DN肾组织TRAIL表达与肾组织损伤程度及肾功能密切相关,提示TRAIL在DN疾病进展中具有重要作用。

英文摘要：

Objective To investigate the expression of tumor necrosis factor related apoptosis inducing ligand（ TRAIL） in the patients with diabetic nephropathy（ DN） and the relationship between TRAIL expression and renal tissue injury. Methods Thirty-six patients with type 2 diabetes mellitus and biopsy identified DN were recruited for this study,and 9 patients with normal kidney tissues after renal hamartoma or cancer resection were collected as the control group. All the patients were selected from the department of nephrology in Daping Hospital from January 2010 to December 2013. The demographic data and clinical data of all the patients were collected. TRAIL expression in renal tissues was detected with immunohistochemical assay,and its correlation with clinical data and renal tissue injury was analyzed. Results TRAIL was mainly expressed in cell membrane and / or cytoplasm of renal tubular epithelial cells,and its expression level rose along with the severity of renal tubulointerstitial injury. TRAIL expression was positively correlated with systolic blood pressure,quantitative urinary protein,urinary N-acetyl-β-D-glucosaminidase,urinary albumin /creatinine,uric acid,urea nitrogen,serum creatinine and cystatin C,and negatively correlated with estimated glomerular filtration rate（ r =- 0. 936,P〈0. 01）. Conclusion TRAIL expression is closely related to renal tissue injury severity and renal function, which suggests that TRAIL plays an important role in DN progression.