目的:研究白细胞分化抗原CD34在IgA肾病肾小管间质病变中的表达变化。探讨其在IgA肾病进展过程中的作用。方法:应用免疫组织化学双标记技术检测不同小管间质病变程度的IgA肾病患者肾组织内CD34和α-平滑肌激动蛋白(α-SMA)的表达。肾小管间质病变分级采用Katafuchi积分。详细收集每例患者肾活检时的24h尿蛋白定量(TUPr)及内生肌酐清除率(Ccr),并与免疫病理结果进行相关分析。结果:无小管间质病变组未见CD34的表达,α-SMA仅表达于间质的动脉壁;轻度小管间质病变组CD34和α-SMA表达散在,主要见于小管间质受损部位;中、重度病变组较轻度病变组CD34和α-SMA的表达显著增加(P〈0.05);小管间质内CD34的表达与α-SMA的表达及TUPr、Ccr具有显著相关性(P〈0.05)。结论:随小管间质病变进展而出现的CD34表达增多可能在IgA肾病中发挥重要作用。
Objective:To study the expression of cluster differentiation antigen, CD34, in tubulointerstitiurn of IgA nephropathy and explore its roles in the progression of IgA nephropathy. Methods:The expressions of CD34 and α- SMA in renal tissue of IgA nephropathy with different tubulointerstitial lesions were detected with a double- labeling immuncstaining method. Tubulointerstitial lesion was classified by using Katafuchi scale. Results of total urine protein for 24 hours (TUPr) and creatinine clearance rate (Ccr) of each patient were carefully collected. The clinical indexes were analyzed with immunopathological indexes by using of linear correlation. Results: In group with no tubulointerstistial lesion, no expression of CD34 was detected and α- SMA only expressed on interstitial arterial wall; CD34 and α - SMA expressed dispersedly in group with mild tubulointerstitial lesion, mainly in areas with tubulointerstitial iniury; their expressions in groups with moderate and severe tubulointerstitial lesion were significant higher than those in group with mild tubulointerstitial lesion( P〈 0.05). The expression of CD34 was significantly correlated with the expression of α- SMA, TUPr,and Ccr (P〈0.05). Conclusion: Increased CD34 expression with the progression of tubulointerstitial lesion might play important rotes in IgA nephropathy.