| Purpose:Idiopathic nephropathy?IMN?is an autoimmune nephropathy characterized by the deposition of subepithelial immune complexes in the glomerular basement membrane and the formation of complement membrane attack complexes accompanied by the thickening of the glomerular basement membrane.So far,pathological renal biopsy is the gold standard for the diagnosis of this disease.Phosolipase A2 receptor(PLA2R has been shown to be expressed in the glomerular podocytes of IMN and has received extensive attention.In this study,real-time fluorescence quantitative PCR?q RT-PCR?was used to detect the expression level of serum microrna-217?mi RNA-217?in IMN patients,analyze the change of mi RNA-217 content in IMN patients,study the relationship between mi RNA-217 and TCM syndrome types in IMN patients,and study the correlation between mi RNA-217 and PLA2R to explore new serological markers of IMN.Material and method:1.A total of 153 patients diagnosed with IMN by percutaneous renal biopsy in Liaoning University of Traditional Chinese Medicine hospital from September 2017 to April 2019 were selected,including 48 in the IMN group,44 in the non-IMN nephropathy group and 43 in the healthy control group.Test all the object of study of serum creatinine?Cr?,urea nitrogen?Bun?,uric acid?UA?,serum(inhibition C?Cys C?,total protein?TP?,albumin?propagated?and prealbumin?PA?,triglycerides?TG?,low density lipoprotein?LDL-C?,high-density lipoprotein?HDL-C?,estimated glomerular filtration rate?e GFR?,white blood cell count?WBC?,hemoglobin?Hb?,urine trace albumin?m ALB?,24 hours urinary protein quantitative?24 h UTP?,serum PLA2 R antibody.2.The expression level of serum mi RNA-217 in IMN group,non-imn group and healthy control group was detected by q RT-PCR,and the relative expression level of mi RNA was calculated by 2-??CT.3.The symptoms of patients in IMN group and non-IMN nephropathy group were collected by professional physicians according to the diagnostic criteria,and the TCM syndrome types of patients were judged;4.SPSS 17.0 was applied for statistical analysis of all data.Results:1.UA,TG,TC,LDL,ALB,TP,Cys C,m ALB and 24 hUTP in IMN group were higher than those in normal control group?P<0.05?.TG,TC,LDL,TP,ALB,m ALB,24 h UTP and estimated e GFR in IMN group were higher than those in non-IMN group?P<0.05?.Bun,Cr and GLU in IMN group were lower than those in non-IMN group?P<0.05?.Bun,Cr,UA,TG,TC,Cys C,m ALB,24 h UTP and GLU in the non-IMN group were higher than those in the control group?P<0.05?.e GFR in the non-IMN group was lower than that in the normal control group?P<0.05?.2.In terms of TCM syndrome type deficiency,the proportion of IMN syndrome type deficiency from high to low was 25 cases?52.08%?of spleen and kidney qi deficiency,9 cases?18.75%?of qi and Yin deficiency,6 cases?12.50%?of spleen and kidney Yang deficiency,4 cases?8.33%?of lung and kidney qi deficiency,and 4 cases?8.33%?of liver and kidney Yin deficiency.In the non-IMN group,there were a total of 44 cases,including 15 cases?34.09%?,14 cases?31.82%?,6 cases?13.64%?,5cases?11.36%?,and 4 cases?9.09%?.The constitutive ratio of this deficiency syndrome in the two groups was different,and the difference was statistically significant?P<0.05?.In terms of standard evidence,the syndrome type composition ratio from high to low was 39 cases?81.25%?of blood stasis syndrome,33 cases?68.75%?of water dampness syndrome,16 cases?33.33%?of dampness and heat syndrome,and 7 cases?14.58%?of dampness syndrome.In the non-IMN group,there were a total of 44 cases,with 35 cases?79.55%?,28 cases?63.64%?,11 cases?25.00%?,and 10 cases?22.73%?,respectively.The empirical composition ratio of the two groups was different,and the difference was not statistically significant?P>.05?.3.The target gene mi RNA-217 and internal reference gene hsa-mir-16 were detected by q RT-PCR,and the relative mi RNA expression was determined by 2-??CT.The multiples of IMN group and non-IMN nephropathy group were 0.15 and 2.22,respectively,compared with the control group.The relative expression of mi RNA-217 in the INM group was significantly lower than that in the control group?P < 0.05?,and that in the non-IMN nephropathy group was significantly higher than that in the control group?P < 0.05?.The area under the ROC curve?AUC?of mi RNA-217 was0.936,the sensitivity was 81.2%,and the specificity was 79.4%.The relative expression of mi RNA-217 was negatively correlated with the quantity of PLA2 R antibody?r=-0.841,P<0.01?.4.IMN group the mi RNA-217 and pathological situation analysis,the mi RNA-217 expression in patients with stage ? relatively higher than ?,? period,kidney tissues Ig G positive?93.75%?,the relative expression of mi RNA-217 is lower.The PLA2 R antibody positive rate in kidney tissue was 83.33%,the relative expression of mi RNA-217 was lower in patients with positive PLA2 R antibody;In terms of electron microscopy,the relative expression of mi RNA-217 was lower in patients with electron dense deposition.5.TCM syndrome type deficiency syndrome and mi RNA-217 were analyzed by single-factor chi-square analysis.The relative expression level of mi RNA-217 was higher in patients with spleen and kidney qi deficiency than other syndromes.The difference was significant compared with spleen and kidney Yang deficiency syndrome,liver and kidney Yin deficiency syndrome,and qi and Yin deficiency syndrome?P<0.05?.The relative expression level of mi RNA-217 was the lowest in patients with qi and Yin deficiency syndrome which was significantly different from that in patients with spleen and kidney qi deficiency syndrome and lung and kidney qi deficiency syndrome?P<0.05?.The relative expression level of mi RNA-217 in patients with spleen and kidney qi deficiency syndrome and liver and kidney Yin deficiency syndrome was lower than that in patients with spleen and kidney qi deficiency syndrome and lung and kidney qi deficiency syndrome,and the difference was significant?P<0.05?.Conclusion:1.The expression of serum mi RNA-217 in patients with IMN is down-regulated,and serum mi RNA-217 may be a good marker for the diagnosis of IMN;Serum mi RNA-217 was lower in patients with more severe pathology.2.The distribution of TCM syndromes in IMN patients was different.The deficiency of spleen and kidney qi was higher in this case,while the blood stasis was higher in the other cases.3.The expression of serum mi RNA-217 was higher in spleen and kidney qi deficiency syndrome and lower in qi and Yin deficiency syndrome.4.Serum mi RNA-217 is negatively correlated with serum PLA2 R antibody. |
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