高血壓腎病患者轉化生長因子β1的表達及臨床意義

[摘要] 目的 該研究旨在探討TGF-β1水平對原發性高血壓腎病的早期診斷價值。方法 方便選取2010年6月—2016年6月在該院接受治療的確診為高血壓腎病的成年患者82例作為實驗組，選擇同期入院的65名健康者作為對照組，比較分析兩組患者的血清TGF-β1的水平、尿mAlb含量及eGFR，并分析其相關性。結果 高血壓腎病組血漿TGF-β1（46.6±12.8）ug/L、尿微量白蛋白（mAlb）（18.0±4.2） mg/L水平顯著高于正常對照組，而腎小球濾過率估計值（eGFR）（50.7±12.5）mL/（min·1.73 m2）顯著低于對照組。高血壓腎病組TGF-β1、mAlb與eGFR相比較均具有極為顯著的負相關（r2=0.9779）；而對照組TGF-β1、mAlb與eGFR之間無顯著的關聯性（r2=0.6762）。結論 高血壓腎病的病理改變伴隨著一個復雜的包含血管損傷與修復的病理性血管重塑過程。高血壓腎病的發病機制可能與TGF-β1/Smad 信號轉導功能的增強有關。

[關鍵詞] 高血壓腎病；生長因子；腎小球濾過率

[中圖分類號] R697 [文獻標識碼] A [文章編號] 1674-0742（2016）12（b）-0014-03

Clinical Significance of TGF-β1 Expressions in Hypertensive Nephropathy

YUAN Shou-ping

Department of Renal Medicine， Putian First Hospital， Fujian Province， Putian， Fujian Province， 351100 China

[Abstract] Objective The aim of the present study is to explore the potential values for the early diagnosis of primary hypertensive nephropathy. Methods Convenient selection adult patients with hypertensive nephropathy who were treated in our hospital from June 2010 to June 2016 were diagnosed as experimental group. The experimental group consisted of 82 consecutive adult hypertensive nephropathy patients. Sixty five healthy controls were enrolled in this study. The levels of serum TGF-β1， urinary mAlb and eGFR in the two groups were compared and analyzed， and the correlations were analyzed between the two groups. Results The plasma TGF-β1（46.6±12.8）μg/L and microalbuminuria （mAlb） （18.0±4.2）mg/L in the urine were significantly higher and the estimated glomerular filtration rate （eGFR） （50.7±12.5）mL/（min·1.73 m2）was significantly lower in the Hypertensive Nephropathy Group than in the Control. In the Hypertensive Nephropathy Group， TGF-β1 and mAlb showed a significant correlation with eGFR（r2=0.9779）； whereas no siginificant correlations were noted between them in the control group（r2=0.6762）. Conclusion The pathogenesis involved in the process of hypertensive nephropathy might be associated with a complex pathologically vascular remodeling that is comprised of vascular injury and repair. The mechanisms of hypertensive nephropathy might be related to an enhanced function of TGF-β1/Smad signaling pathway

[Key words] Hypertensive nephropathy；Glomerular filtration rate；Growth factors.

轉化生長因子（TGF）-β1是一種同源二聚體多肽，其生物學作用相當廣泛，對細胞的分化、增殖具有調節作用，參與血管再生及重構等生物過程。研究表明，TGF-β1作為一種生長因子存在，高血壓和其靶器官損害與該基因變異密切相關[1]。腎小球間質纖維化、硬化以及不敏感激素反應可能是由于TGF-β1增多引起，任其發展會導致終末期腎病[2]。除此還發現高血壓患者血壓與該患者血漿里TGF-β1含量呈正比[3]。研究表明，TGF-β1與高血壓腎病的發生、發展和預后密切相關[4]。但其病因至今尚未完全闡明。為探討TGF-β1水平對原發性高血壓腎病的早期診斷價值，方便選取2010年6月—2016年6月在該院接受治療的82例高血壓腎病的成年患者的血漿TGF-β1水平進行了檢測，并與常規應用于評估的指標進行對照，現報道如下。……