Objective To observe the relationship between the degree of renal interstitial injury and the expression levels of P2X4 and NALP3 in diabetic nephropathy (DN). Methods Forty-five DN patients were assigned to observation group and 40 ones undergoing renal hamartoma resection to control group. Biochemical indicators and the expression levels of P2X4,NALP3,IL-1β and IL-18 in renal tubular epithelial cells were compared between 2 groups. Results The levels of urea nitrogen,serum inosine and urinary protein were significantly higher (P<0.01) and those of plasmatotal protein,albumin and glomerular filtration rate lower (P<0.01) in observation than in control group. Findings of immunohistochemisty fluorescence showed that P2X4,NALP3,IL-1β and IL-18 were all high expression in observation group;findings of laser confocal microscope showed that the expressions of P2X4,NALP3,IL-1β and IL-18 all reinforced in observation group. Both P2X4 and NALP3 were significantly positively related to urea nitrogen,serum inosine,urine protein,renal interstitial inflammation,renal interstitial fibrosis,kidney tubules atrophy,IL-1β and IL-18 (P<0.05) and negatively to glomerular filtration rate (P<0.05). Conclusion The expression levels of P2X4 and NALP3 are positively related to damage degrees of renal interstitial inflammation significantly and can be used as a new monitoring index to provide basis for clinical diagnosis,treatment and prognosis.%目的 观察糖尿病肾病患者肾间质损伤程度与P2X4、NALP3表达水平变化的相关性.方法 将45例糖尿病肾病患者设为观察组,40例肾错构瘤行切除术患者设为对照组.比较两组生化指标水平及肾小管上皮细胞P2X4、NALP3、白细胞介素-1β、白细胞介素-18的表达水平.结果 观察组尿素氮、血清肌苷、尿蛋白水平显著高于对照组(P<0.01),血浆总蛋白、血浆清蛋白、肾小球滤过率水平显著低于对照组(P<0.01).免疫组化荧光结果显示观察组P2X4、NALP3、白细胞介素-1β、白细胞介素-18均为高表达;激光共聚焦结果显示观察组P2X4、NALP3、白细胞介素-1β、白细胞介素-18表达均显著增强.观察组P2X4和NALP3分别与尿素氮、血清肌苷、尿蛋白、肾间质炎症、肾间质纤维化、肾小管萎缩、白细胞介素-1β和白细胞介素-18呈显著正相关(P<0.05),与肾小球滤过率呈显著负相关(P<0.05).结论 P2X4和NALP3的表达水平与肾间质炎症损伤程度存在显著正相关,可以作为一种新的监测指标,为临床诊断、治疗与预后评价提供参考依据.
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