TLR4 及HGF 在糖尿病肾病患者中的表达及其与疾病进展的关系

Expression of TLR4 and HGF in patients with diabetic nephropathy and its relationship with disease progression

摘要:

目的 探讨Toll 样受体4（TLR4）及肝细胞生长因子（HGF）在糖尿病肾病（DN）中的表达并进一步分析其与疾病进展的关系。方法 选取2014 年9 月-2016 年9 月南华大学附属南华医院收治的DN患者72 例（DN 组），根据24 h 尿蛋白定量（24 h pro）高低分为24 h pro 高组（n =31）和24 h pro 低组（n =41），另选取同期在该院体检的健康人群20 例为对照组。比较3 组血清及尿液标本中HGF 水平及肾组织中TLR4 表达。结果 与对照组比较，DN 组患者肾组织中TLR4 表达量升高（P <0.05），24 h pro 低组患者肾组织中TLR4 表达量低于24 h pro 高组，但两组比较差异无统计学意义（P >0.05）；免疫组织化学结果显示，对照组TLR4 呈阴性表达，而DN 组TLR4 呈高表达，但24 h pro 低组和24 h pro 高组间TLR4 表达情况差异无统计学意义（P >0.05）。与对照组比较，DN 组患者血清及尿液中HGF 水平均升高，且24 h pro 高组血清及尿液中HGF 水平高于24 h pro 低组，差异有统计学意义（P <0.05）。结论 DN 患者肾组织中TLR4 的表达与DN 病情进展密切相关，HGF 在DN 的发生、发展中有作用。

Abstract:

Objective To study the expression of Toll like receptor 4 (TLR4) and hepatocyte growth factor (HGF) in patients with diabetic nephropathy (DN) and its relationship with progression of DN. Methods A total of 72 cases with DN from Sep. 2014 to Sep. 2016 in our hospital were selected as DN group, then divided into high 24 h pro group (n = 31) and low 24 h pro group (n = 41) according to 24 h urinary protein quantitation (24 h pro); anther 20 healthy people in our hospital were selected as the control group. The levels of HGF and the expression of TLR4 in renal tissue were compared between the three groups. Results Compared with the control group, the expression of TLR4 in the renal tissue of DN group was significantly higher (P < 0.01), the expression of TLR4 in the renal tissue of low 24 h pro group was slightly lower than that in high 24 h pro group, but there was no significant difference between the two groups (P > 0.05). Immunohistochemical results showed that TLR4 was negative in the control group, while was overexpressed in DN group, but there was no significant difference between low 24 h pro group and high 24 h pro group (P > 0.05). Compared with the control group, the levels of HGF in serum and urine of DN group were significantly increased, and the levels of HGF in serum and urine of high 24 h pro group was significantly higher than that of low 24 h pro group, respectively; there was significant difference between the two groups (P < 0.05).Conclusion The expression of TLR4 in renal tissue of DN is closely related to the progression of DN; HGF also plays a role in the development and progression of DN.