Study On The Relationship Between The Lesions Of Renal Interstitial Vascular In IgA Nephropathy And Anti-endothelial Cell Antibodies And Clinical Results

Objective: IgA nephropathy is one of the most common primary glomerular diseases in China.The pathogenesis of this disease is not yet clear.Some patients have renal interstitial vascular changes,which may affect the development of the disease;The target cells of anti-endothelial cell antibodies(AECA)are vascular endothelial cells;the purpose of this experiment is to investigate the relationship between renal interstitial vascular lesions and anti-endothelial cell antibodies and clinical in IgA nephropathy.Methods: The study was performed in 216 patients from January to December 2017 in the Department of Nephrology of first People's Hospital of Yunnan Province.All patients underwent percutaneous biopsy of the kidney,renal histopathology and immunopathology,diagnosis of IgA nephropathy,and exclusion of systemic diseases.Secondary IgA nephropathy caused by systemic diseases such as lupus erythematosus,allergic purpura,viral hepatitis,tumors,and rheumatoid arthritis.According to the presence or absence of renal interstitial vascular lesions,renal interstitial vascular lesions and renal interstitial vasculopathy lesions were divided into groups to observe the clinical indicators of the two groups;indirect immunofluorescence was used to measure serum anti-endothelial cell antibodies;renal tissue CD34,Vascular endothelial growth factor(VEGF)immunohistochemical staining was used to observe the expression of renal interstitial blood vessels.The anti-endothelial cell antibodies and interstitial CD34 and vascular endothelial growth were analyzed between renal interstitial vascular lesions and renal interstitial vascular lesions.Differences in factor expression.Results: 1.Blood pressure,urinary protein,urinary protein/creatinine ratio,serum creatinine and urea nitrogen were significantly different between the two groups(P<0.01).2.Of the 56 patients with renal interstitial vasculopathy,11(19.64%)were positive for anti-endothelial cell antibodies,and 20(12.5%)were positive for anti-endothelial cell antibodies in 160 patients without renal interstitial vasculopathy.There was no difference in the positive rate of anti-endothelial cell antibodies and hematuria between the two groups(P>0.05).3.The percentage of CD34-positive area in the renal interstitial blood vessels in the angiopathy group was less than that in the non-vascular disease group.There was a significant difference between the two groups(P<0.05).The percentage of the VEGF-positive area in the renal interstitial area accounting for the visual field was not found in the two groups.Difference(P>0.05).4.The percentage of CD34-positive area of renal interstitial vascular lesions and renal interstitial blood vessels in the IgA nephropathy was proportional to the percentage of visual field area,serum creatinine,diastolic blood pressure,and glomerular filtration rate(P<0.05).Conclusions: 1.Renal interstitial vascular changes in patients with IgA nephropathy.2.Serum anti-endothelial cell antibody positive can not be used alone to judge the pathological changes of renal interstitial blood vessels in IgA nephropathy.3,IgA nephropathy renal interstitial blood CD34 positive area percentage of the visual field reduction can be used to assess renal interstitial vascular disease.4.The percentage of VEGF-positive area in the renal interstitial blood vessels of the IgA nephropathy in the visual field area was not correlated with renal interstitial vascular disease.5,IgA nephropathy renal interstitial vascular disease and blood pressure,creatinine,urea nitrogen,urinary protein,urine protein / creatinine ratio and renal interstitial blood CD34-positive area accounted for the percentage of visual field area,may increase the kidney Damage affects disease progression.