| Objectives: To analyze the association of urinary hEGF with severity of tubulointerstitial lesion and glomerular in IgA nephropathy. A none wound means was provided to assess the onset, development and prognosis of renal disease in clinical practice.Methods: Seventy IgAN patients and twenty MCD patients (as control group) were included in this study. The degree of histological lesions was graded according to WHO. IgAN patients with grades 1-2 were classified as the mild lesion group, including 17 male patients and 7 female patients. IgAN patients with grades 3-4 were classified as the moderate lesion group, including 11 male patients and 19 female patients. IgAN patients with grades 5 were classified as the severe lesion, including 12 male patients and 4 female patients. There were altogether 40 male patients age from 15 to 49, with 26.2±9.3 years old, 169.3±7.2cm in height, 67.1±11.4kg in weight, and were 30 female patients from 15 to 53 with 33.0±8.8 years old, 160.9±3.9cm in height, 61.8±8.7kg. hEGF urinary concentration was detected by using radioimmunoassay (RIA). Area of Bowman capsule, tubular, and capillary were measured by CMIAS 2000 true color image analysis system. Area of interstitial (I) = total area (C)- (area of Bowman capsule+ tubular+ capillary). Volume of interstitial= I/C.Results: 1 The ratio of male and female in IgAN group was 1.33: 1. Age, height, weight, and BMI show no significant difference among the four groups, P>0.05. 2 Blood pressure in patients of control group and mild lesion group shows no significant difference, P>0.05. SBp in patients of moderate lesion group was higher than the patients of control group and mild lesion group, P<0.01. SBp and DBp in patients of severe lesion group were higher than the other three groups, P<0.01. 3 Ccr in severe lesion group were significantly lower than the other groups, P<0.01, and show no significant difference among the three groups, P>0.05. 4 Scr in severe lesion group was significantly higher than the other groups, P<0.01, and showed no significant difference among the three groups, P >0.05. 5 Osmotic pressure (OP) of urine showed significantly difference among IgAN groups, P<0.01. With increase of severity of pathological lesion, the value decreased. There were no significant difference between the control group and the mild lesion group, P>0.05. 6 Urinary protein in 24 hours showed significantly difference among IgAN groups, P <0.01. With increase of severity of pathological lesion, the value increased. The average values of the severe lesion group come up to the standard of NS. 7 The values of IV were 18.6±1.8% in control group, 23.0±2.9% in mild lesion group, 36.2±6.7% in moderate lesion group, and 55.0±6.5% in severe lesion group respectively. There was significantly difference among the four groups, P<0.01. 8 hEGF urinary concentration was 56.8±6.7μg/L in control group, 97.6±15.1μg/L in mild lesion group, 36.1±6.9μg/L in moderate lesion group, and 6.7±2.6μg/L in severe lesion group. There was significantly difference among the four groups, P<0.01. 9 The average quantity of cell in glomeruli was 65±6 in control group, 76±15 in mild lesion group, and 91±15 in moderate lesion group. There was significantly difference among the three groups, p<0.01. 10 hEGF urinary concentration correlated with Ccr, r=0.56, P<0.01. Model equation was EGF= 7.1218+0.5099Ccr, P<0.01. With the increase of Ccr, hEGF urinary concentration increased gradually. There was negative correlation between hEGF urinary concentration and Scr, r=-0.45, P<0.01. With Scr increasing, hEGF urinary concentration decreased gradually. 11 IV correlated with proteinuria , r=0.62,P﹤0.01. Model equation was Upro=-0.0404+0.0948IV,P﹤0.01. With increase of severity of tubulointerstitial lesion, the level of proteinuria increased gradually. IV correlated with Ccr, r=-0.73, P<0.01. Model equation was IV=55.9350-0.2167Ccr, P<0.01. With increase of severity of tubulointerstitial lesion, Ccr decreased gradually. IV correlated Scr, r=0.61,... |
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