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目的观察在急进性肾小球肾炎（ＲＰＧＮ）和Ⅳ型狼疮肾炎（ＬＮ）中，单核细胞趋化蛋白１（ＭＣＰ１）的表达和单核巨噬细胞（ＭФ）的浸润情况。方法采用免疫组织化学和原位杂交技术检测１０例ＲＰＧＮ和１８例Ⅳ型ＬＮ患者肾活检组织。结果（１）ＲＰＧＮ中，ＭФ广泛存在于新月体和肾间质小管中，ＭФ在肾小囊内、肾间质的数量分别与肾小管内的数量相关（ｒ＝０８５１，Ｐ＜００１，ｒ＝０６９３，Ｐ＜００５），ＭＣＰ１无明显表达（Ｐ＞００５）；（２）Ⅳ型ＬＮ中，ＭФ弥漫浸润于肾小球内和间质小管中，ＭФ在肾小球内的数量与肾小囊周围的数量相关（ｒ＝０６２２，Ｐ＜００１），ＭＣＰ１在肾小球区域１２例阳性（Ｐ＜００５），并与尿蛋白量、ＭФ浸润数量相关（ｒ＝０４００，Ｐ＜００５，ｒ＝０５６８，Ｐ＜００１）。结论（１）在两病变组中，ＭФ参与肾小球和肾间质小管的炎症病变；（２）在Ⅳ型ＬＮ组中，肾小球内ＭФ的浸润可能部分受ＭＣＰ１趋化作用的影响，但在肾间质小管中和ＲＰＧＮ组中ＭФ浸润却与ＭＣＰ１表达无相关性，提示在炎症的不同时相和部位，ＭФ趋化调控的多因素性。
Objective To observe the expression of monocyte chemoattractant protein-1 (MCP1) and the infiltration of mononuclear macrophage (MΦ) in patients with acute progressive glomerulonephritis (RPGN) and type Ⅳ lupus nephritis (LN) Methods Immunohistochemistry and in situ hybridization were used to detect the renal biopsies in 10 cases of RPGN and 18 cases of type Ⅳ LN. Results (1) In the RPGN, MФ is widely found in the crescent and renal interstitial tubules. The number of MФ in the renal cysts and the renal interstitium is related to the number of tubules (r = 0851, P < 001, r = 0693, P <005), no significant expression of MCP 1 (P> 005); (2) TypeⅣ LN, MФ diffuse infiltration in the glomerular and stromal The number of MФ in the glomerulus was correlated with the number of peritubular cysts (r = 0622, P <001). MCP1 was positive in glomeruli (P <005 ), And correlated with the amount of urine protein and the number of MФ infiltration (r = 0400, P <005, r = 0568, P <001). Conclusions (1) MФ is involved in inflammatory pathological changes of glomerular and renal interstitial tubules in two lesion groups; (2) MⅣin glomerular infiltration may be partially chemotactic MФ infiltration in the tubulointerstitial tubules and RPGN group had no correlation with the expression of MCP-1, suggesting the multi-factorial regulation of chemotaxis of MΦ at different phases and locations of inflammation.