Research Of The Relationship Between The Deposition Of Immune Substance And The Clinical Classification, TCM, Syndrome Type In The IgA Nephropathy

ObjectivesRecent studies have pointed out that the deposition of immune complex composition on the pathogenesis of IgA nephropathy has probably prompted the important significance.Abnormal glycosylation of IgA antibodies are the central aspect of its pathogenesis,some of which manifested as abnormal in patients with IgA metabolism in the liver to clear decrease and in mucosal infection manifested as abnormal to generate an increase in IgA,while a small number of patients showed to get special receptors on Glomerular mesangium.Through reviewing and analyzing different clinical types and TCM IgA nephropathy patient's immune material composition,this thesis probes into the possible pathogenesis and reveal IgA nephropathy syndromes exist in real terms and the possible impact of factors.It enriches IgA nephropathy connotations of traditional Chinese medicine,in order to provide a scientific and objective indicators of micro-data for the combinative treatment of traditional Chinese and western medicine in future.MethodsAccording to IgA nephropathy inclusion criteria,this thesis selects at Guangdong Provincial TCM Hospital diagnosed 71 cases of patients with IgA nephropathy,aged from 14 to 59 years old,the average age is 34.3±11.1 years old.The average serum creatinine level of all patients is below 177umol / L, the average is 94.1±28.2umol / L.Selected patients have to undergo a nephritic puncture to obtain nephritic tissue,paraffin-embedded conventional sections,conventional HE,PAS,PASM and Masson staining;To use direct immunofluorescence assay to check IgG,IgA,IgM antibodies' deposition of degrees.To group the selected cases by clinical manifestations and symptoms of TCM sindrome,this thesis uses analysis of variance or rank sum test comparing the indicators of inter-group differences.It uses bivariate correlation analysis to evaluate the correlation between indicators;and evaluate the indicators different clinical types of the impact of IgA nephropathy happenedResultsThe study shows that with the increasing of sediment yield of IgA,both the Urine protein amount of 24 hours and the hematourimetry increase,but it has no significance in statistics(p>0.05);There is a positive correlation between the ediment yield of IgM and the Urine protein amount of 24 hour in statistics(p<0.05);In the nephrotic syndrome of clinical types,the IgA+IgM-deposition type takes possession of 90%in the four immunocomplex -deposition types,butthere is no significance in statistics compared with the IgA+IgM+IgG-deposition type.In the chronic nephritis of clinical types,the IgA+IgM+IgG-deposition type takes possession of 50%,there is obvious difference in the statistics compare with other types(p<0.05).There is no obvious difference in the immunocomplex-deposition types of the uabnormal urine and the gross hematuria(p>0.05).The IgA+IgM-deposition is the most type in the TCM sindrome of splenic and nephric QI deficiency;the IgA+IgG-deposition type is the most tpye in the TCM sindrome of hepatic and renal YIN deficiency;the IgA+IgM+IgG-deposition type is the most tpye in the TCM sindrome of both QI and YIN deficiency,there is obvious difference compare to the IgA+IgG -deposition type and IgA+IgM-deposition type(P<0.05).ConclusionOur study shows that there is a positive correlation between the ediment yield of IgM and the Urine protein amount of 24 hour in IgAN patient;The most immunocomplex-deposition type of chronic nephritis in the clinic is IgA+IgM +IgG-deposition type;IgM can be considerde as a evidence of the diagnosis ofsplenic and nephric QI deficiency;IgG can be considerde as a evidence of the diagnosis of hepatic and renal YIN deficiency;When the types of immunocomplex-deposition increase,the the TCM sindrome of hepatic and renal YIN deficiency appears more frequently;Because the time and the cases of illness in this Study are not enough,we had not find enough evidence to prove that there is a relationship between the nephrotic syndrome and the IgA+ IgM-deposition type or gross hematuria and the IgA+IgG-deposition type.We hope that we can get a new result in the further study.