The Clinical Study On The Relationship Between Hcy With Glomerular Endothelial Function And VEGF In Patients With Iga Nephropathy

Objective:The bojective of the study is to explore the correlation between plasma Hcy level and glomerular endothelial function and vascular endothelial growth factor in patients with IgA nephropathy of different severity,to predict the possibility of progression to ESRD in patients with IgA nephropathy in early stage,and to provide predictive indicators for prognosis judgement and treatment of IgA nephropathy Methods:A retrospective analysis was made of the data of inpatients from January 2013 to December 2016.Forty patients with IgA nephropathy,at the same time,10 patients with distal nephrectomy in our urology department were selected as the normal control group.The expression of vascular endothelial growth factor in renal tissue was detected by immunohistochemical technique.To observe the correlation of Hcy index with clinical index(serum creatinine,urea nitrogen,24-hour urinary protein,folic acid)and pathological index(level of vascular endothelial growth factor in renal tissue).Results:1.The expression of vascular endothelial growth factor in renal tissue of IgA nephropathy was significantly higher than that of normal control group,and the expression of vascular endothelial growth factor was different among different Lee grades.The expression of vascular endothelial growth factor in renal tissue of Lee grades 1-4 increased significantly with the increase of pathological damage,while the expression of vascular endothelial growth factor in some glomeruli of IgA nephropathy patients with Lee grades 5was the lowest.(P<0.05).2.In Lee grade 1-4 IgA nephropathy group,the expression of vascular endothelial growth factor was positively correlated with serum creatinine,blood urea nitrogen and urinary protein,but not with serum folic acid level.In Lee grade 5 groups,the expression of vascular endothelial growth factor was not correlated with serum creatinine,blood urea nitrogen,urine protein quantification and serum folic acid level(P < 0.05).3.In Lee grade 1-4 IgA nephropathy patients,plasma Hcy level was positively correlated with the expression of vascular endothelial growth factor in renal tissue,and positively correlated with serum creatinine,blood urea nitrogen and urinary protein.In Lee grade 5 groups,plasma Hcy was not significantly correlated with the expression of vascular endothelial growth factor in renal tissue,but positively correlated with serum creatinine,blood urea nitrogen and urinary protein.(P<0.05).Conclusion:1.There was a positive correlation between the level of VEGF and glomerular endothelial injury in IgA nephropathy patients.With the aggravation of endothelial injury,the level of vascular endothelial growth factor increased.2.The level of plasma Hcy in IgA nephropathy patients was positively correlated with the expression of vascular endothelial growth factor in renal tissue,and positively correlated with the degree of glomerular endothelial damage.Serum Hcy can be used to judge the degree of glomerular endothelial damage in IgA nephropathy patients.