IgA肾病肾小管间质中淋巴细胞亚群分布及其临床意义探讨

摘要

目的:探讨IgA肾病( IgA nephropathy ,IgAN )肾小管间质中淋巴细胞亚群分布与临床肾功能的关系及其意义. 方法:对48例IgAN患者穿刺肾组织石蜡切片行Masson三色染色,按牛津分类将48例IgAN患者分为T0、T1和T2组,用CD4、CD8和CD20一抗行免疫组化染色,分别标记T淋巴细胞亚型( CD4、CD8 )和B淋巴细胞(CD20). 采用Image-Pro Plus图像分析系统分析免疫组化结果,结合相关病理参数(肾小球硬化、肾小管萎缩、间质纤维化程度)及临床指标,应用SPSS 13.0统计软件进行统计学分析. 结果:CD4+、CD8+、CD20+的细胞数量在不同纤维化组别间差异有统计学意义( P<0.05). CD4+、CD8+、CD20+的细胞数量与不同临床、病理指标呈正相关. 结论:间质中浸润淋巴细胞的不同数量和类型影响 IgAN临床特征及肾脏纤维化的进展.%Objective:To investigate the distribution and clinical significance of lymphocytes and their subsets in renal tubulointerstitium of IgA nephropathy (IgA nephropathy , IgAN).Methods:We stained paraffin sections of 48 cases of IgAN patients for Masson .According to Oxford classification , 48 cases of IgAN patients were divided into 3 groups:T0,T1 and T2.CD4, CD8 and CD20 primary antibodies were immunohistochemically stained , and marked as T lymphocyte subsets(CD4+, CD8+), B lymphocytes(CD20+), respectively.Immunohistochemistry results were analyzed by Image-Pro Plus image system, combined with the related pathological parameters (glomerulosclerosis, tubular atrophy, interstitial fibrosis ) and clinical index .We also used SPSS 13 statistical software for statistical analysis .Results:There was a significant difference between the quantity of CD 4+, CD8+, CD20+cells between different fibrosis groups, P<0.05.The number of cells of CD4 +, CD8 +and CD20 +was positively correlated with different clinical and pathological indexes .Conclusion:The number and type of infiltrating lymphocytes in renal tubular interstitium influence IgAN clinical features and the progress of renal fibrosis .