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| 激素干预对IgA肾病患儿Toll样受体9表达的影响 |
| Toll-like receptor 9 expression and effect of glucocorticoid treatment in children with IgA nephropathy |
| 投稿时间：2016-05-25 |
| DOI：10.3969/j.issn.1000-0399.2017.01.001 |
| 中文关键词: IgA肾病,儿童 Toll样受体9 激素 |
| 英文关键词: IgA nephropathy,children Toll-like receptor 9 Glucocorticoid |
| 基金项目:安徽省卫生厅医学科研项目（项目编号：13FR019） |
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| 中文摘要: |
| 目的 探讨激素治疗对IgA肾病（IgAN）患儿Toll样受体9（TLR-9）表达水平的影响及临床意义。方法 2013年1月至2016年3月在安徽省儿童医院治疗的45例确诊IgAN患儿为研究对象，分血尿组、轻度蛋白尿组、中度以上蛋白尿组，血尿组采用对症治疗，轻度蛋白尿组、中度以上蛋白尿组分别在血尿组的基础上予小剂量激素及中等剂量以上激素治疗或冲击治疗，治疗前、治疗后第7、15天常规检测IgAN患儿临床指标及外周血单个核细胞（PBMCs）TLR-9的表达情况。结果 治疗前，3组患儿TLR9-mRNA及蛋白表达（0.31±0.07，0.31±0.15；0.55±0.07，0.55±0.11；0.60±0.07，0.60±0.12）较健康儿童（0.10±0.35，0.10±0.35）均处在高表达状态，差异有统计学差异（P<0.05）；治疗后第7天，中度以上蛋白尿组24 h尿蛋白定量较治疗前下降，差异有统计学意义（P<0.05）；治疗后第15天，轻度蛋白尿组血清清蛋白水平较治疗前上升，差异有统计学意义（P<0.05），中度及以上蛋白尿组24 h尿蛋白定量、TLR-9表达量（0.23±0.11，0.23±0.13）较治疗前下降，血清清蛋白水平上升，差异均有统计学意义（P<0.05）；IgAN患儿TLR-9表达量与血清清蛋白呈线性负相关（r=-0.824，P<0.05），与24 h尿蛋白定量呈线性正相关（r=0.820，P<0.05）。结论 TLR-9在IgAN患儿体内处于高表达状态，激素治疗后与24 h尿蛋白定量及血清清蛋白水平呈线性相关。 |
| 英文摘要: |
| Objective To explore the relation between TLR-9 and clinical therapy of treating IgAN with glucocorticoid. Methods Forty-five children with diagnosis of IgAN as the research object were divided into hematuria group, mild proteinuria group, moderate proteinuria group, and hematuria group with the symptomatic treatment;mild proteinuria and moderate proteinuria groups were combined with small dose and above medium dose of glucocorticoid treatment even shock treatment on the basis of hematuria grou.p. The clinical indicators and TLR 9 expression in peripheral blood mononuclear cells (PBMCs) in IgAN children's blood were detected before treatment and 7 days,15 days after treatment respectively. Results Before treatment, TLR9-mRNA and protein(TLR9/β-actin) expression in three groups of children[(0.31±0.07,0.31±0.15; 0.55±0.07,0.55±0.11;0.60±0.07,0.60±0.12)] were in a higher statethan those in the normal children[(0.10±0.35, 0.10±0.35)] with statistical significance (P<0.05).Seven days after treatment, 24h urinary protein level was significantly decreasedin above moderate proteinuria group(P<0.05). Fifteen days after treatment,24h urinary protein levelwasdecreased significantlycompared with before treatmentin mild proteinuria group, and the serum albumin level was increased significantly with statistical significance (P<0.05); 24h urinary protein level and TLR9 expression[(0.23±0.11, 0.23±0.13)] was decreased significantly in moderate or above proteinuria group compared with before treatment, and the serum albumin level rose obviously(P<0.05). TLR9 expression showed linear negative correlationwith serum albumin (r=-0.824, P<0.05)and linear positive correlation with 24h urinary protein level (r=0.820,P<0.05) in children with IgAN. Conclusion TLR9 is on a high expression state in children with IgAN, and the expression of TLR-9 has linear correlation with 24h urinary proteinlevel and the level of serum albuminafter glucocorticoid treatment. |
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