目的：探讨Toll样受体（TLR）4、TLR7在儿童原发性肾病综合征（PNS）不同肾脏病理类型中的表达及临床意义。方法纳入110例确诊且经肾活检的PNS患儿，采用免疫组化方法检测肾组织中的TLR4、TLR7，以21例肾母细胞瘤患儿的正常肾组织为对照，分析比较PNS患儿与对照儿童间以及不同病理分型PNS患儿间，肾组织TLR4、TLR7表达的差异。结果不同病理类型PNS患儿和对照组之间肾小管中TLR4、TLR7表达的差异均有统计学意义（P<0.01），其中肾小管TLR4表达水平以MCD型最高，其次MN型、MsPGN型、FSGS型，两两比较差异均有统计学意义（P<0.05）；而肾小管TLR7表达水平以MsPGN型最高，其次为MN型、MCD型、FSGS型，两两比较差异也均有统计学意义（P<0.05）。结论 TLR4、TLR7在PNS患儿肾组织中表达增高，且其表达水平可能与病理类型相关。%Objective To study the expression and clinical significance of toll-like receptor (TLR) 4 and TLR7 in primary nephrotic syndrome (PNS) of different pathological types in children. Methods Renal expressions of TLR4 and TLR7 were amined and analyzed retrospectively in renal biopsy specimens from 110 PNS patients and 21 healthy controls by immunohisto-chemical method. According to the renal pathologic classification of PNS, the TLR4 and TLR7 expression levels in PNS of dif-ferent types were compared. Results Compared with the renal tissue of healthy controls, the expression level of TLR4 on renal tissue of PNS patients was significantly increased (P<0.01). Among MN, MsPGN and FSGS, the highest expression of TLR4 was observed in MCD (P<0.01). Compared with the renal tissue of healthy controls, the expression level of TLR7 in re-nal tissue of PNS patients was also significantly increased (P<0.01). Among MCD, MN and FSGS, the highest expression of TLR7 was observed in MsPGN (P<0.01). Conclusions TLR4 and TLR7 expression levels are increased in renal tissue of PNS patients and the expression levels may be correlated with renal pathological types.
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