【作者】 张亮；

【导师】 刘玉强；

【作者基本信息】 山东大学 ， 外科学， 2010， 硕士

【摘要】 目的：探讨梗阻性肾病患者血清中Ⅲ型前胶原(Procollagen TypeⅢ, PCⅢ)及Ⅲ型前胶原氨基末端肽(Amino Terminal Peptide of ProcollagenⅢ, PⅢNP)浓度的变化与肾组织纤维化的相关性。由此筛选出能及早预测肾积水肾脏纤维化程度的具有临床意义的实验室指标,以求对肾积水的治疗有所指导。方法：本院泌尿外科收治肾积水患者30例,分为3组,肾脏轻度积水组、中度积水组、重度积水组各10例,另外取10例肾透明细胞癌(术后经病理证实)及肾外伤患者作为对照组；采用放射免疫法测定各组患者血清中PCⅢ及PⅢNP含量；三组肾积水患者各留取肾组织标本5例,对照组留取正常肾组织标本5例(肾透明细胞癌根治术患者取癌旁5cm以外的肾组织),标本行免疫组化SP法染色测定Ⅲ型胶原含量,HE染色测定肾小管肾间质病变程度,对血清中PCⅢ及PⅢNP含量与肾小管肾间质病变比率行相关性分析。结果：①三组肾积水患者血清中PCⅢ及PⅢNP值较对照组均升高,且随积水程度加重血清中PCⅢ及PⅢNP值逐渐升高,各组间比较有统计学意义(P<0.05)。②各组肾积水患者肾小管、肾间质病变比率较对照组差异有统计学意义(P<0.05),且随积水程度加重,肾小管、肾间质病变比率增加。③血清PCⅢ及PⅢNP浓度与病变肾小管、肾间质比率呈正相关(r=0.749,P<0.05)。结论：肾积水患者血清中PCⅢ及PⅢNP值较对照组明显升高,且随积水程度加重血清中PCⅢ及PⅢNP值逐渐升高；肾积水患者血清PCⅢ及PⅢNP值与肾脏肾小管、肾间质病变比率呈正相关,表明血清PCⅢ及PⅢNP与肾积水时肾间质病变纤维化密切相关。因此,在排除肾外脏器纤维化的前提下,推测血清PCⅢ及PⅢNP对早期判断肾积水肾脏纤维化进程具有一定意义。更多还原

【Abstract】 ObjectiveThis study was to explore the relevance of the changing of collagen typeⅢin serum of obstructive nephropathy and renal fibrosis, then we could elucidate the diagnosis value of serum PCⅢand PⅢNP concentration on the renal fibrosis.MethodsThirty patients with hydronephrosis fibrosis were separated to three group:the group of Mild renal fibrosis, Moderate renal fibrosis and Severe renal fibrosis group. Also take 10 cases of renal trauma in patients with renal cell carcinoma as the control group. The serum of each patient was reserved before operation. Collagen typeⅢwas measured by immunohistochemical staining and PCⅢand PⅢNP were measured by radioimmunoassay (RIA). The five renal tissue specimens of each patient were taken out to measure the tubular interstitial lesions by HE staining and to measure the collagenⅢcontents by immunohistochemical SP staining. We analyzed the correlation between the tubular interstitial lesions and the PCⅢand PⅢNP in the serum. Results①. PCⅢand PⅢNP in serum of three groups of renal fibrosis in patients with hydronephrosis were higher than the control group, and the value of the PCⅢand PⅢNP in the serum increased gradually with the increasing degree of hydronephrosisi.②. Interstitial fibrosis in kidneys of patients of hydronephrosis was observed more pronounced than the control groups,and the rate of the tubular interstitial lesions increased gradually with the increasing degree of hydronephrosisi.③. PCⅢand PⅢNP in serum were positively correlated with the the tubular interstitial lesions.Conclusions:①.PCⅢand PⅢNP in serum of three groups of renal fibrosis in patients with hydronephrosis are higher than the control group,and the value of the PCⅢand PⅢNP in the serum increased gradually with the increasing degree of hydronephrosisi. The PCⅢand PⅢNP in serum are correlative with renal interstitial fibrosis in hydronephrosis. PCⅢand PⅢNP in serum can be used to indicate renal fibrosis in hydronephrosis on condition that other organ fibrosis could be excluded.更多还原