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目的:探讨细胞表面糖蛋白(CD44)在儿童IgA肾病(IgAN)发病中的作用及其与肾小管间质损害的关系。方法:46例IgAN患儿按临床表现分为3组:孤立性血尿组14例,血尿蛋白尿组17例,肾病综合征组15例;按病理分级分为3组:病理Ⅰ+Ⅱ级组23例,Ⅲ级组14例,Ⅳ级组9例。设肾活检正常对照组4例。采用免疫组化SP法检测病例组与对照组肾组织CD44的表达,并分析其与肾小管间质病变程度的相关性。结果:①正常肾组织仅有少量CD44表达。②IgAN患儿肾组织中CD44的表达均较对照组明显增高,不同临床表现组中肾病综合征组最高,孤立性血尿组最低,且与IgAN患儿的病理分级密切相关。③IgAN患儿肾组织CD44的表达与肾小管间质损害程度呈正相关。结论:CD44参与了儿童IgAN的发病和肾小管间质损害,与IgAN的进展及预后有关。
Objective: To investigate the role of cell surface glycoprotein (CD44) in the pathogenesis of IgA nephropathy (IgAN) in children and its relationship with tubulointerstitial damage. Methods: 46 cases of IgAN were divided into 3 groups according to their clinical manifestations: 14 cases of isolated hematuria, 17 cases of urine proteinuria and 15 cases of nephrotic syndrome. The pathological grade was divided into 3 groups: pathological Ⅰ + Ⅱ group 23 cases, Ⅲ group 14 cases, Ⅳ group 9 cases. Kidney biopsy in normal control group of 4 patients. Immunohistochemical SP method was used to detect the expression of CD44 in renal tissue of patients and controls, and its correlation with the degree of tubulointerstitial lesions was analyzed. Results: ①Normal kidney tissue only a small amount of CD44 expression. ② The expression of CD44 in IgAN children was significantly higher than that in control group. The highest incidence of nephrotic syndrome and the lowest in isolated hematuria group were found in different clinical manifestations, which were closely related to the pathological grade of IgAN. (3) There was a positive correlation between the expression of CD44 in IgAN children and the degree of tubulointerstitial damage. Conclusion: CD44 is involved in the pathogenesis of IgAN in children and tubulointerstitial damage, which is related to the progress and prognosis of IgAN.