背景：肾脏纤维化是糖尿病肾病(diabetic kidney disease,DKD)的主要发病机制之一。人类抗原R(HuR)与肾脏细胞上皮间质转分化密切相关。已有文献证实在糖尿病肾病患者中HuR表达升高,但不同分期的患者HuR表达变化尚不明确。方法：选取2014年1月-2019年5月在南京医科大学第一附属医院经肾活检明确诊断的DKD患者165例。通过免疫组化的方法检测HuR的表达。各组患者HuR表达采用非参数检验。HuR水平与临床指标进行Spearman相关分析。结果：HuR在肾脏中表达增高，主要位于肾小管上皮细胞，均在细胞核内表达。HuR在不同分期的糖尿病肾病患者肾组织中表达有差异，其中IIb期与III期、IIb期与IV期、III期与IV期之间存在显著的统计学差异（p<0.001），而IIa期与IIb期之间没有差异。DKD患者HuR表达与年龄、血清肌酐、尿素氮、血尿酸、C反应蛋白、甲状旁腺激素成正相关，与估算肾小球滤过率（estimated glomerular filtration rate, eGFR）、血红蛋白、糖化血红蛋白、25羟维生素D成负相关。结论：糖尿病肾病病理分型IIb以上越重的DKD患者HuR表达更高。HuR的表达与肾功能相关临床指标具有相关性。
Renal fibrosis is one of the main pathogenesis of diabetic kidney disease. Human antigen R (HuR) is associated with tubularepithelial mesenchymal transition. It has been confirmed that the expression of HuR is increased in the kidney tissue of diabetic nephropathy patients, but the difference of HuR expression in patients with different renal pathological stages is unclear.Methods: A total of 165 DKD patients diagnosed by renal biopsy admitted to the first affiliated hospital of Nanjing medical university from January 2014 toMay 2019 were enrolled.The expression of HuR was detected by immunohistochemistry. The comparison of HuR expression was tested by nonparametric test. Spearman’s rank correlation was performed for correlation analysis between HuR levels and clinical factors.Results: The expression of HuR was increased in the kidney, mainly in the nucleus of tubular epithelial cells. There were significant differences between diabetic nephropathy stage IIb and stage III, stage IIb and stage IV, stage III and stage IV (P< 0.001), Wheareas no difference between stage IIa and stage IIb was observed. HuR expression is positively correlated with age, serum creatinine, urea nitrogen, serum uric acid, C-reactive protein and PTH, and negatively correlated with eGFR, hemoglobin, glycosylated hemoglobin and 25-OH-vitamin D.Conclusion: The expression of HuR is positive related to the severityof pathological stages（IIb，III，IV）. The expression of HuR was correlated with clinical indicators of renal function.