肾小球C4d沉积在慢性肾病早期诊断及预后的价值分析(1)
摘 要：目的 分析肾小球沉积C4d在慢性肾病中的价值，为临床提供可靠依据。方法 本次研究选自2014年1月～2017年1月医院肾内科肾脏病理检验患者194例，其中慢性腎脏病86例，急性肾损伤性疾病108例，均采用免疫组织化学检验肾小球C4d，进行沉积分型，慢性肾脏病对象划分为有效组(8周内随访蛋白尿得到控制)、对照组。对比慢性肾脏病、急性肾损伤患者肾小球C4d沉积情况，分析慢性肾脏病在C4d沉积表达中是否存在独立作用。分析肾小球C4d沉积是否在慢性病治疗中起到作用。结果 慢性肾脏病肾小球C4d阳性率、毛细血管袢区沉积伴系膜区沉积比重高于急性肾脏病对象，差异有统计学意义(P<0.05)。肾小球毛细血管袢区C4d沉积成为慢性肾脏病疾病未获得控制的独立影响因素(P<0.05)。结论 肾小球C4d沉积在早期诊断及判断预后具有价值，肾小球C4d毛细血管袢区沉积伴系膜区沉积慢性肾脏病风险较高，同时在疗效预测上有更高的价值。
关键词：慢性肾脏病；诊断；肾小球血管袢；C4d
, 百拇医药 中图分类号：R446.1；R692 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.08.025
文章编号：1006-1959(2018)08-0081-03
Value of Glomerular C4d Deposition in Early Diagnosis and Prognosis of Chronic Kidney Disease
XIE Qin
(Department of Nephrology，Xuanhan County People's Hospital，Xuanhan 635150，Sichuan，China)
Abstract：Objective To analyze the value of glomerular deposition C4d in chronic nephropathy.Methods From January 2014 to January 2017，194 cases of renal pathology were selected，including 86 cases of chronic kidney disease and 108 cases of acute renal injury disease.Glomerular C4d was detected by immunohistochemistry to classify sediments.Subjects with chronic kidney disease were divided into effective groups(control of proteinuria within 8 weeks)and controls.To compare the glomerular C4d deposition in patients with chronic kidney disease and acute kidney injury，and to analyze the independent role of chronic kidney disease in the expression of C4d deposits.Analysis of glomerular C4d deposition plays a role in the treatment of chronic diseases.Results The positive rate of glomerular C4d in chronic kidney disease，deposition in the capillary region，and deposition in the mesangial area were higher than those in acute kidney disease，and the difference was statistically significant(P<0.05).The deposition of C4d in the glomerular capillary loop area was an independent factor that did not control chronic kidney disease(P<0.05).Conclusion The glomerular C4d deposition is valuable in early diagnosis and prognosis.Glomerular C4d in the capillaries of the glomerulus is associated with a higher risk of deposition of chronic kidney disease in the mesangial area，and has a higher value in predicting the efficacy.
, 百拇医药
Key words：Chronic kidney disease；Diagnosis；Glomerular vasospasm；C4d
慢性肾脏病(chronic kidney disease，CKD)是一类常见的慢性器质性病变，我国成人慢性肾脏病发病率为13.2%。慢性肾脏病的病因复杂，因糖尿病、高血压、急性肾炎、高脂血症等相关疾病发生率上升，慢性肾脏病发生率呈上升趋势[2]。慢性肾脏病危害大，可致代谢紊乱，进入临床期，患者可出现水肿、瘙痒等症状，生命质量下降，随着病情的进展，最终会进展为肾脏病终末期即尿毒症，不得不进行长期透析、肾脏移植治疗，死亡率明显上升[3]。故及早诊断慢性肾脏病非常必要，临床诊断慢性肾脏病的方法依赖血、尿实验室指标，但这些方法并非“金标准”，病理检验是慢性肾脏病主要方法，具有创伤性，对急性肾损伤、慢性肾脏病仍有限。C4d是一种补体片段，自发现以来用于实体器官移植领域的排斥反应分析上，肾小球C4d沉积与肾移植免疫排斥反应病理特征之间的关系已得到认可，并作为移植肾功能预后的预测指标[4]。肾小球C4d在慢性肾病早期诊断及预后并不完全清楚。本次研究选自2014年1月～2017年1月医院肾内科肾脏病理检验194例，其中慢性肾脏病86例，急性肾损伤性疾病108例，分析肾小球C4d在鉴别诊断、疗效预测中价值。, 百拇医药(谢琴)
关键词：慢性肾脏病；诊断；肾小球血管袢；C4d
, 百拇医药 中图分类号：R446.1；R692 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.08.025
文章编号：1006-1959(2018)08-0081-03
Value of Glomerular C4d Deposition in Early Diagnosis and Prognosis of Chronic Kidney Disease
XIE Qin
(Department of Nephrology，Xuanhan County People's Hospital，Xuanhan 635150，Sichuan，China)
Abstract：Objective To analyze the value of glomerular deposition C4d in chronic nephropathy.Methods From January 2014 to January 2017，194 cases of renal pathology were selected，including 86 cases of chronic kidney disease and 108 cases of acute renal injury disease.Glomerular C4d was detected by immunohistochemistry to classify sediments.Subjects with chronic kidney disease were divided into effective groups(control of proteinuria within 8 weeks)and controls.To compare the glomerular C4d deposition in patients with chronic kidney disease and acute kidney injury，and to analyze the independent role of chronic kidney disease in the expression of C4d deposits.Analysis of glomerular C4d deposition plays a role in the treatment of chronic diseases.Results The positive rate of glomerular C4d in chronic kidney disease，deposition in the capillary region，and deposition in the mesangial area were higher than those in acute kidney disease，and the difference was statistically significant(P<0.05).The deposition of C4d in the glomerular capillary loop area was an independent factor that did not control chronic kidney disease(P<0.05).Conclusion The glomerular C4d deposition is valuable in early diagnosis and prognosis.Glomerular C4d in the capillaries of the glomerulus is associated with a higher risk of deposition of chronic kidney disease in the mesangial area，and has a higher value in predicting the efficacy.
, 百拇医药
Key words：Chronic kidney disease；Diagnosis；Glomerular vasospasm；C4d
慢性肾脏病(chronic kidney disease，CKD)是一类常见的慢性器质性病变，我国成人慢性肾脏病发病率为13.2%。慢性肾脏病的病因复杂，因糖尿病、高血压、急性肾炎、高脂血症等相关疾病发生率上升，慢性肾脏病发生率呈上升趋势[2]。慢性肾脏病危害大，可致代谢紊乱，进入临床期，患者可出现水肿、瘙痒等症状，生命质量下降，随着病情的进展，最终会进展为肾脏病终末期即尿毒症，不得不进行长期透析、肾脏移植治疗，死亡率明显上升[3]。故及早诊断慢性肾脏病非常必要，临床诊断慢性肾脏病的方法依赖血、尿实验室指标，但这些方法并非“金标准”，病理检验是慢性肾脏病主要方法，具有创伤性，对急性肾损伤、慢性肾脏病仍有限。C4d是一种补体片段，自发现以来用于实体器官移植领域的排斥反应分析上，肾小球C4d沉积与肾移植免疫排斥反应病理特征之间的关系已得到认可，并作为移植肾功能预后的预测指标[4]。肾小球C4d在慢性肾病早期诊断及预后并不完全清楚。本次研究选自2014年1月～2017年1月医院肾内科肾脏病理检验194例，其中慢性肾脏病86例，急性肾损伤性疾病108例，分析肾小球C4d在鉴别诊断、疗效预测中价值。, 百拇医药(谢琴)