| Objective:To investigatethe expression of CD3、CD20、CD68 in renal tissue from primary glomerular nephropathy.In addition,to explore the relationship between CD3,CD20,CD68 and clinical pathology.Methods: 75 patients with primary glomerular nephropathy were enrolled in the Department of Nephrology of Affiliated Hospital of Yan’an University from 2016.01 to 2016.12.According to the pathological types,minimal change disease(MCN),mesangial proliferative glomerulonephritis(Ms PGN),focal segmental glomerulosclerosis(FSGS),membranoproliferative glomerulonephritis(MPGN),membranous nephropathy(MN)and Ig A nephropathy(Ig AN);According to the Lee classification criteria of Ig A nephropathy,Ig AN was divided into II-V grade;According to the degree of renal damage is divided into mild group,moderate group,severe group;In accordance with the 24 hour urinary protein(24h-Upro)quantitative divided into three groups;According to the serum creatinine,divided into the normal group(Scr≤104umol/L)and the increased group(Scr>104umol/L);Based on estimated glomerular filtration rate(e GFR)divided into three groups.The patients in the control group(n=5)were enrolled in the study.The research object of recording age and gender,hypertension,SBP,DBP,24h-Upro,Scr,e GFR,CD3,CD20,CD68,pathological type,intensity of physiological indexes of renal tissue nephropathy,integral degree of renal damage.SPSS20.0 statistical software was used to analyze the data of this study,and analyzing the relationship between the expression of CD3,CD20 and CD68 in renal tissues and the clinical pathological parameters.Result:1.The expression of CD3,CD20 and CD68 in renal tissue of Primary glomerular nephropathy.The 75 patients with PGN were enrolled in this study,including male and female,with an average age of(41.95±16.08);Compared with normal kidney tissues,CD3,CD20 and CD68 were significantly high expressed in the kidney tissues of glomerulonephritis group(P<0.05).2.The relationship between CD3,CD20 and CD68 in renal tissue and pathological type,pathological index and lesion degree(1)The renal biopsy pathological diagnosis types of 75 patients,MCN in 5 cases(6.7%);Ms PGN in 8 cases(10.7%);FSGS in 11 cases(14.7%);MPGN in 0 cases(0%);MN in 32 cases(42.7%);Ig AN in 19 cases(25.3%).The results showed that in FSGS group the expression of CD3,CD20 and CD68 compared with MCD group,Ms PGN group,MN group,Ig AN group were significantly increased(P <0.05).(2)The CD3,CD20 and CD68 in renal tissue of Lee III-V groups were higher than those in Lee II group,and the expression of CD3,CD20 and CD68 in IV group and V group were significantly higher than those in II group(P <0.05).CD68 in III group was higher than those in II group(P <0.05).(3)CD3,CD20,and CD68 expression and glomerular score,renal vascular score,and tubule lesions score were positively correlated(CD3 r = 0.481,0.387,0.510,P< 0.01;CD20 r = 0.478,0.469,0.542,P< 0.01;CD68 r = 0.592,0.550,0.667,P < 0.01).(4)According to the calculation of renal pathological score of quality,will be divided into: mild group 51 cases,moderate group 15 cases and severe group 9 cases.Compared with the expression of CD3,CD20 and CD68 in moderate and severe lesions groups were significantly higher than those in mild group(P < 0.05),but expression of renal tissue CD3,CD20 and CD68 in moderate lesion group and severe lesion group were not significant the difference(P > 0.05).3.Relationship between CD3,CD20,CD68 and urine protein(1)The expression of CD3 and CD20 in(Upro≥3.5g)group higher than(Upro< 1.0g)and(1.0g≤Upro<3.5g)groups,but the differences were not statistically significant(P> 0.05).Compared with(Upro<1.0g)group,the expression of renal tissue CD68 in(1.0g≤Upro<3.5g)group and(Upro≥3.5g)group were significantly increased,the difference were statistically significant(P < 0.05).(2)The correlation analysis showed that there was no significant correlation between CD3,CD20 and 24h-Upro(P>0.05),but renal tissue CD68 had positive correlation with 24h-Upro(r=0.265,P = 0.022).4.Relationship between CD3,CD20,CD68 and serum creatinine.The expression of CD3,CD20 and CD68 in Scr elevated group was higher than that in Scr normal group,and the difference was significant(P < 0.05).5.Relationship between CD3,CD20,CD68 and glomerular filtration rate(1)Compared with e GFR 60 ml·min-1·(1.73m2)-1 group,The expression of CD3 CD20 and CD68 in e GFR 30-59 ml · min-1·(1.73m2)-1 group and e GFR 30 ml·min-1·(1.73m2)-1 group were increased,e GFR 30-59 ml·min-1·(1.73m2)-1 group and e GFR 60 ml·min-1·(1.73m2)-1 group had significant difference(P< 0.05);The expression of CD3 in e GFR< 30 ml·min-1·(1.73m2)-1 group and in e GFR 60 ml·min-1·(1.73m2)-1 group,showed significant difference(P< 0.05).(2)The correlation analysis showed that CD3,CD20 and CD68 were negatively correlated with e GFR(CD3,r=-0.303,P=0.008;CD20,r=-0.400,P=0.000;CD68,r=-0.433,P=0.000).Conclusion:1 The expression of CD3,CD20 and CD68 in renal tissue may has a certain effect on the occurrence of primary glomerular nephropathy.2 CD3,CD20 and CD68 in renal tissue may be involved in mesangial cell proliferation,glomerular sclerosis,tubules atrophy and formation of renal interstitial fibrosis,may be used as a pathological index to evaluate the degree of glomerular and tubulointerstitial damage.3 The expression of CD3,CD20 and CD68 in renal tissues was related to the degree of pathological damage of kidney,may be used as an index of progressive renal pathological damage.4 The immune inflammatory reaction mediated by the expression of CD3,CD20 and CD68 in renal tissue may be involved in the formation of proteinuria and progression of renal function deterioration,is expected to be a predictive index of renal function,and has some clinical value in the evaluation of renal function. |
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