肾小球疾病患者血清血管内皮生长因子的变化及其意义

目的　研究原发和继发性肾小球疾病 (GD)患者血清血管内皮生长因子 (VEGF)的质量浓度变化及免疫抑制剂对其影响 ,分析其与相关临床指标的关系。方法　采用双抗体夹心ABC ELISA法检测患者及对照者血清VEGF质量浓度。结果　GD患者血清VEGF显著高于对照组。GD临床分组中的慢性肾小球肾炎组 (CGN)、隐匿性肾小球肾炎组 (LGN)、紫癜性肾炎组 (HSPN)、狼疮性肾炎组 (LN)患者血清VEGF均高于对照组 ,而各组之间无明显差异。未服用免疫抑制剂患者血清VEGF高于对照组 ,服用者与对照相比无显著性差异 ;GD患者免疫抑制剂冲击治疗后与冲击前对比血清VEGF显著下降。肾病综合征组 (NS)患者肾病期血清VEGF高于缓解期 ;膜性肾病 (MGN)患者血清VEGF与 2 4h尿蛋白排泄量呈正相关。LN患者血清VEGF与血浆γ 球蛋白、血抗 dsDNA抗体滴度呈正相关。结论　VEGF参与GD的发病机制 ,与蛋白尿的发生发展有关。免疫抑制剂可降低血清VEGF质量浓度。LN患者血清VEGF质量浓度与LN的活动有关

Alteration and significance of vascular endothelial growth factor in the serum of patients with glomerular diseases

Objective To study the concentration alteration of serum vascular endothelial growth factor (VEGF) in patients with primary and secondary glomerular diseases (GD), the effect of immune inhibitors on the concentration, and analyze the relationship between VEGF concentration and some clinical indexes. Methods Serum VEGF concentration of GD patients was determined by sandwich ABC-ELISA. Results All of the GD patients had higher level of serum VEGF than the control group. Of the 5 groups divided according to the clinical classification, patients of chronic glomerulonephritis(CGN) group, latent glomerulonephritis(LGN) group, Henoch-Schonlein purpura nephritis(HSPN) group and lupus nephritis(LN) group had higher serum VEGF level than the control group, respectively, with no difference among the above groups. The patients without taking immune inhibitors had higher serum VEGF level than the control group,while no difference was observed between the patients taking immune inhibitors and the control group.Patients with glomerulonephritis had a significantly lower serum VEGF level after receiving immunosuppression aggressive therapy than before. The serum VEGF level of nephrotic syndrome in nephrotic phase was higher than in remission stage. In membranous glomerulonephritis serum VEGF correlated positively with 24-hour proteinuria excretion. The serum VEGF level correlated positively with anti-dsDNA Ab titer and the concentration of γ globulins in LN. Conclusion Cytokine VEGF is involved in the pathogenesis of glomerulonephritis, and in the occurrence and progression of proteinuria. Immunosuppression therapy can inhibit the expression of VEGF. In LN patients, the serum VEGF level is related to LN activity.