血 尿cd80和supar在肾小球微小病变和局灶节段性肾小球硬化患者的变化和意义-changes and significance of blood and urine cd80 and supar in patients with glomerular micro-lesion and focal segmental glomerulosclerosis.docxVIP

目录中文摘文··········································································································1英文摘要···········································································································4研究论文血、尿CD80和suPAR在肾小球微小病变和局灶节段性肾小球硬化中的变化及意义前言···········································································································8材料与方法····························································································10结果·········································································································16附图········································································································17附表········································································································21讨论·········································································································22结论·········································································································25参考文献································································································26综述原发性局灶性阶段性肾小球硬化的血尿标志物······························30致谢············································································································38个人简历········································································································39血、尿CD80和suPAR在肾小球微小病变和局灶节段性肾小球硬化中的变化及意义摘要背景:肾小球微小病变（MinimalChangeDisease，MCD），是一组临床以单纯性肾病综合征为主要病变的肾小球疾病。局灶阶段性肾小球硬化（focalsegmentalglomeruloscerosis,FSGS）也主要表现为肾病综合征，少数表现为慢性肾炎。FSGS病变肾小球主要分布在皮髓交界处，由于早期FSGS肾活检未取到皮髓交界组织或所取肾小球数目较少及肾小管萎缩和肾间质纤维化不明显等未能诊断，给两者的鉴别诊断带来困难。但两种疾病临床表现相似，肾病理表现、疗效、预后明显不同。近几年有研究发现，MCD患者尿中CD80排泄量增加，而FSGS患者血清中suPAR（可溶性尿激酶型纤溶酶原激活物受体）水平增加。我们的研究的目的是评估检测患者尿CD80和血清suPAR是否可以用作鉴别MCD和FSGS非创方法方法：1研究对象：2014年3月至2014年8月于河北医科大学第二医院肾内科住院患者，并行经皮肾活检，病理诊断为MCD及FSGS、MN：肾小球微小病变（MCD）43例、局灶性节段性肾小球硬化（FSGS）20例及I期膜性肾病（对照组）15例[均除外继发因素]，收集病人晨起中段尿10ml，不抗凝静脉血3ml，待凝固后，以3000r/min，离心10min分离血清，保存于-80度冰箱，以备后期测定CD80和s