| Objective:Chronic kidney diseases(CKD) has become a worldwide disease that affects human health, along with the application of renal biopsy and people on the improvement of the awareness, and as the gold standard for diagnosis, pathological diagnosis in CKD plaies more and more important role. in guiding treatment and judging prognosis. In various primary kidney disease, Ig A nephropathy(Ig AN) is the highest incidence of pathologic type in our country and even in southeast Asia, Serum Ig A level is increased and Ig A with C3 is deposited in the mesangium and the junction between the mesangium and basement membrane. A wide spectum of change is seen histologically; Idiopathic membranous nephropathy(IMN) affects all age groups,but adulted more commonly. Capillary wall thickening without proliferation or inflammation is present in all glomeruli. Light microscopy reveals characteristic spikes on the thickened capillary wall by PASM staining. The clinical feature is heavy proteinuria or nephrotic syndrome with lipid metabolism disorders. IMN is one of the most important causes of the nephrotic syndrome in adults. Studies have shown that lipid metabolic disorder can accelerate the process of CKD and the progress of the cause of renal failure.Adipocyte- type fatty acid binding protein(A- FABP), called FABP4 or a P2, is one cytoplasm protein. FABP4 is one of the nine types of FABP and is the most typical and the most significant biological activities of subtypes.FABP4 was discovered in the adipocyte, macrophages and endothelium in some organs. FABP4 not only invoives in lipid metabolism but also takes part in inflammation and immunoreaction.In this experiment, ELISA was employed to detect serum A-FABP level of 52 patients with Ig A nephropathy and idiopathic membranous nephropathy. Serum cholesterol, triglyceride, low density lipoprotein cholesterol, and the expression of high-density lipoprotein cholesterol of the patients were detected in same groups, The aim is to clarify the relationship between the serum level of A-FABP and the relationship between renal biopsy pathology classification.Methods1 Case bolting and groupingA total of 52 samples(25 patients with IMN Ⅰstage; 27 patients with Ig AN Ⅱ stage) were selected from 230 patients with renal biopsy, in renal medicine of cangzhou city center hospital between January 2013 and December 2013. At the same time, according to the 52 cases clinical manifestations of divided into nephrotic syndrome group(26 cases), 26 patients of chronic glomerulonephritis group. Into the group of patients with renal biopsy on the day of fasting serum specimen collection, keeped at-20 cryopreserved℃ selecting 18 in renal medicine clinic examination of the normal control group.2 All serum samples were detected serum A- FABP using enzyme-linked immunosorbent assay(ELISA).3 The detection of blood specimens of total cholesterol, triglyceride, low density lipoprotein cholesterol and high density lipoprotein cholesterol.4 Statistical processing: data analysis by SPSS 17. 0 statistical software for Windows. Measurement data of normal distribution(x±s) said, when using t/t is compared between two groups’ inspection, measurement data using the median in part by skewness of the distribution(minimum and maximum) was described,The skewness distribution of two groups to compare the Mann-Whitney U inspection;Analysis application SPSS17.0 statistical analysis software processing, inspection level of 0.05.Results1 Compared with control group[18.98±(12.60 19.67)], the serum A-FABP level(18.98±4.29ng/l)in idiopathic membranous nephropathy was no obviously higher(P>0.05).Compared with control group(4.47±1.37mmol/L), blood total cholesterol(5.29 ±1.58 mmol/L) in idiopathic membranous nephropathy was no obviously higher(P>0.05).Compared with control group(1.70 ±0.84), Triglyceride values(2.54±1.22mmol/L) was no obviously higher(P> 0.05).Compared with control group(2.67±0.93mmol/L), Low density lipoprotein cholesterol value(2.54±1.22mmol/L) was no obviously higher(P>0.05).Compared with control group(1.30±0.17mmol/L), High-density lipoprotein cholesterol value(1.16±0.27mmol/L) was no significant decrease(P> 0.05).2 Compared with control group[18.98(12.60 19.67)], the serum A-FABP level(14.93±7.32ng/l) in Ig A nephropathy was no obviously higher(P> 0.05).Compared with control group(4.47±1.37mmol/L), blood total cholesterol(4.89 ±0.87 mmol/L) in Ig A nephropathy was no obviously higher(P>0.05).Compared with control group(1.70 ±0.84mmol/L), Triglyceride values(2.28±1.59mmol/L) was no obviously higher(P>0.05).Compared with control group(2.67±0.93 mmol/L), Low density lipoprotein cholesterol value(3.12±1.01 mmol/L) was no obviously higher(P>0.05).Compared with control group(1.30±0.17mmol/L), High-density lipoprotein cholesterol value(1.19±0.19mmol/L) was no significant decrease(P>0.05).3 Compared with control group[18.98(12.60 19.67)], the serum A-FABP level(20.00±4.00ng/l) in nephrotic syndrome was obviously higher(P<0.05).The elevels of blood total cholesterol(5.89±1.30 mmol/L),triglyceride values(2.73±1.39mmol/L) low density lipoprotein cholesterol value(3.56±0.88mmol/L) in nephrotic syndrome compared with control group,these were obviously higher(P<0.05).Compared with control group(1.30±0.17 mmol/L),High-density lipoprotein cholesterol value(1.19 ±0.19mmol/L) was no significant decrease(P>0.05),that had statistical significance.4 Compared with control group[18.98(12.60 19.67)], the serum A-FABP level(14.05±6.88) in chronic glomerulonephritis was obviously higher(P< 0.05).Compared with control group(1.30 ±0.17 mmol/L),the elevels of blood total cholesterol(4.99±1.06 mmol/L),triglyceride values(2.08±1.39mmol/L), low density lipoprotein cholesterol value(3.07±0.89mmol/L), high-density lipoprotein cholesterol value1(1.23±0.19mmol/L),in chronic glomerulonephritis;the four indexes had no significant difference(P> 0.05).Conclusions:1 Compared with the healthy neonates, the serum A-FABP level and blood total cholesterol, triglyceride, low density lipoprotein cholesterol in the IMN patients, although higher but no statistical difference.Compared with the healthy neonates, the serum A-FABP level in the nephrotic syndrome patients increases noticeably,suggesting that serum A-FABP level can reflect the processing condition of the disease.In 26 patients with nephrotic syndrome group,21 cases of patients with idiopathic membranous nephropathy, idiopathic membranous nephropathy sample size should be increased.2 Compared with the healthy neonates, the serum A-FABP level and blood total cholesterol, triglyceride, low density lipoprotein cholesterol in the Ig AN patients had no significant increase.Compared with the healthy neonates, the serum A-FABP level and blood total cholesterol, triglyceride, low density lipoprotein cholesterol in the chronic glomerular nephritis patients had no significant increase and does not appear lipid metabolic disorders.In 26 patients with chronic glomerular nephritis group, 22 cases of patients with Ig A nephropathy, A- FABP in chronic glomerulonephritis and Ig A nephropathy no clinical diagnostic significance. |
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