复发型PNS患儿肾组织P-糖蛋白170的表达及其临床意义

摘要

Objective To explore the expression and clinical significance of P-glycoprotein 170 (P-gp170) in renal tissue of children with relapsed primary nephrotic syndrome (PNS). Methods Fifty-eight children with PNS diagnosed in our hospital from January 2012 to December 2013 were selected, including 13 cases of incipient PNS without glucocorticoid (GC) treatment (incipient PNS without GC group), 18 cases of relapsed PNS without GC treat-ment (elapsed PNS without GC group), 27 cases of relapsed PNS with GC treatment (elapsed PNS with GC group), and kidney tissues were collected through puncture. Twelve cases of normal renal tissues were selected as control group. The expression of P-gp170 of renal tissues in all groups were detected by immunohistochemical method, and the correlations between P-gp170 expression and disease course, recurrence time, the dosage of glucocorticoid were analyzed. Results The expression of P-gp170 were higher in incipient PNS without GC group, relapsed PNS without GC group and relapsed PNS with GC group than control group, and the differences had statistical significance (all P<0.05). P-gp170 expression had no statistically significant difference between relapsed PNS without GC group and in-cipient PNS without GC group (all P>0.05), and P-gp170 expression were higher in relapsed PNS with GC group than relapsed PNS without GC group, with statistically significant differences (all P<0.05). P-gp170 expression were posi-tively correlated with duration, dosage of glucocorticoid in relapsed PNS with GC group (r=0.651, r=0.788, P<0.05), and was negatively correlated with recurrence time (r=0.794, P<0.05). Conclusion P-gp170 is highly expressed in renal tissue of children with relapsed PNS. Its expression is closely related with duration, recurrence time and dosage of glucocorticoid. Testing the P-gp170 can effectively guide the clinical treatment of children with PNS and judge the prognosis.%目的 探讨复发型原发性肾病综合征(PNS)患儿肾组织P-糖蛋白170 (P-gp170)的表达及其临床意义.方法 共选取2012年1月至2013年12月间我院住院诊治的58例PNS患儿,包括初发未用糖皮质激素(GC)组13例,复发未用GC组18例,复发用GC组27例,穿刺取得肾组织,另取12例正常肾组织作为对照组.采用免疫组化法检测并比较各组肾组织中P-gp170的表达,分析P-gp170表达与复发型PNS患儿病程、首次复发与初发间隔时间、糖皮质激素用量的关系.结果 初发未用GC组、复发未用GC组和复发用GC组三组肾组织P-gp170的表达均高于正常对照组,差异均有统计学意义(P<0.05),而复发未用GC组与初发未用GC组P-gp170的表达差异则无统计学意义(P>0.05),复发用GC组P-gp170的表达又高于复发未用GC组,差异有统计学意义(P<0.05).复发用GC组中P-gp170表达与病程、糖皮质激素用量呈正相关(r=0.651,r=0.788,P<0.05),而与首次复发与初发间隔时间呈负相关(r=-0.794,P<0.05).结论 复发PNS患儿肾组织中P-gp170高表达,其表达与PNS患儿病程、复发时间及糖皮质激素用量有关,对P-gp170进行检测可有效指导PNS患儿的临床治疗,判断预后.