肾性血尿中医分型与尿液炎症因子IL-6、TNF-α、MCP-1
表达和肾脏免疫病病理的相关性研究
陈银凤;王军;俞东容;朱晓玲;王永钧;林宜;孙琳;胡一舟;杨汝春;汤绚丽;张华琴
【期刊名称】《中国中西医结合肾病杂志》 【年(卷),期】2016(017)012
【摘要】目的:探索尿液炎症因子白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和单核细胞趋化蛋白-1(monocyte chemotactic protein-1,MCP-1)表达与肾性血尿中医分型的相关性.方法:收集原发性单纯性血尿(肉眼或镜下血尿且24 h尿蛋白定量＜1.0 g)或血尿伴蛋白尿(24 h尿蛋白定量＜3.5 g)的行肾穿刺的患者,排除继发性、遗传性及其他非肾小球来源的血尿患者共237例,通过中医症候辨证分型,将其分为气阴两虚型80例,风湿内扰型59例,脉络瘀阻型98例,并设40例正常对照;采用酶联免疫吸附剂测定法(enzyme linked immunosorbent assay,ELISA)检测患者尿液炎症因子IL-6、TNF-α和MCP-1表达,通过免疫荧光检测肾脏组织病理改变.结果:气阴两虚型、风湿内扰型和脉络瘀阻型之间,尿液的IL-6、TNF-α和MCP-1浓度差异存在统计学意义,以风湿内扰型尿液的IL-6、TNF-α和MCP-1浓度最高(P＜0.05～0.01);气阴两虚型、风湿内扰型和脉络瘀阻型不同中医证型与肾脏免疫病理存在相关性,气阴两虚型肾脏IgA、IgG和IgM表达最低,IgA和IgM表达差异有统计学意义(P ＜0.05 ～0.01),IgG表达差异无统计学意义(P＞0.05);肾脏补体C3、C1q和Fib亦以气阴两虚型表达最低,其中C3和C1q表达差异有统计学意义(P＜0.05～0.01),Fib表达差异无统计学意义(P＞0.05).结论:肾性血尿中医辨证分型之气阴两虚型、风湿内扰型和脉络瘀阻型,各型尿液中IL-6、TNF-0
和MCP-1浓度差异存在统计学意义,肾脏免疫病理的IgA、IgG、IgM和补体C3、C1q表达亦不尽相同,该类生物标志物是中医辨证论治的物质基础的补充.%Objective:To explore the correlation between the expression of IL-6 、TNF-α、MCP-1 in urinary inflammatory,renal immune pathology and TCM syndrome type of renal hematuria.Methods:Screening patients who undergoing renal biopsying with primary isolated hematuria (gross or microscopic hematuria,24 h urinary protein excretion ＜ 1.0 g) or proteinuria combined with hematuria (24 h urinary protein excretion ＜ 3.5 g) from July 2008 ～ June 2012 in Hangzhou Hospital of TCM.And then excluding the secondary,hereditary and other non-glomerular hematuria,the final number is 237 cases.These cases are classified to Qi-yin dual Deficiency Syndrome 80 cases,wind-dampness Syndrome 59 cases,Blood Stasis Syndrome 98cases.At the same time,set up 40 normal controls as well as comparable with analysis.Determining the IL-6 、TNF-α and MCP-1 in urine by Elisa method,simultaneous determining the corresponding concentration of urine creatinine used as calibration.The pathological changes of renal tissues were detected by immunofluorescence.Results:There are significant differences between these syndromes.The uIL-6 、TNF-αand MCP-1 concentration in wind-dampness group were highest (P ＜ 0.05 ～ 0.01).What's more,the above three different TCM syndromes have correlation with renal immune pathology.The expression of immunoglobulin IgA、IgG and IgM was
lowest in Qi-yin dual Deficiency,which the deposition of IgA and IgM had significant difference (P ＜ 0.05 ～ 0.01),while the difference of IgG has no statistically significance (P ＞ 0.05).The Qi-yin dual Deficiency group had the lowest deposition of C3 、1 q and fibrinogen (Fib).Compared with the other two groups,the expression of C3 and C1q had statistical difference (P ＜ 0.05 ～ 0.01),while the difference of Fib has no statistically significance (P ＞ 0.05).Conclusion:The uIL-6 、TNF-αand MCP-1 concentration in the above three TCM syndrome have significant difference.Also the deposition of IgA,IgG,IgM and C3,Clq are not the same in renal immune pathology.These above biomarkers are the supplement of the material basis of TCM syndrome differentiation and treatment.
【总页数】4页(1053-1056)
【关键词】肾性血尿;中医辨证分型;炎症因子;肾脏病理
【作者】陈银凤;王军;俞东容;朱晓玲;王永钧;林宜;孙琳;胡一舟;杨汝春;汤绚丽;张华琴
【作者单位】浙江省杭州市中医院肾病科 杭州310007;浙江省杭州市丁桥医院肾病科 杭州310000;浙江省杭州市中医院肾病科 杭州310007;浙江省杭州市中医院肾病科 杭州310007;浙江省杭州市中医院肾病科 杭州310007;浙江省杭州市中医院肾病科 杭州310007;浙江省杭州市中医院肾病科 杭州310007;浙江省桐庐县中医院 桐庐311500;杭州胡庆余堂国药号有限公司 杭州310000;浙江省杭州市中医院肾病科 杭州310007;浙江省杭州市中医院肾病科 杭州
肾性血尿中医分型与尿液炎症因子IL-6、TNF-α、MCP-1表达和肾脏免疫病
