摘要
目的探讨肾盂尿β2-微球蛋白(β2一MG)、白蛋白(Alb)、T-H糖蛋白(THP)及免疫球蛋白(IgG)检测在小儿肾积水病肾损害程度判定中的临床意义。方法采用放免法测定78例肾积水患儿病肾肾盂尿β2-MG、Alb、THP及IgG含量,其中36例测定了肾盂尿肌酐(Cr),并以健侧肾盂尿作对照。78例同时行病肾组织学检查分级,并与病肾肾盂尿β2-MG、Alb、THP、IgG及β2-MG/ Cr、Alb/Cr、THP/Cr、IgG/Cr作相关分析。结果①健侧及积水侧肾盂尿β2-MG分别为(130．06±22．02)、(386．18±42．15)ng/ml,Alb分别为(80．52±9．32)、(275．54±69．46)ng/ml,差异有统计学意义(P＜0．05)；尿β2-MG/Cr分别为(0．16±0．04)、(1．57±0．39)ng/μmol,Alb/Cr分别为(0．11±0．03)、(1．07±0．56)ng/μmol,差异均有统计学意义(P＜0．05)。②健侧肾、病肾肾盂尿THP分别为(25．80±9．02)、(31．43±10．56)ng/ml,IgG分别为(15．21±3．56)、(20．52±10．85)ng/ml,差异无统计学意义(P＞0．05)。尿THP/Cr分别为(0．05±0．01)、(0．14±0．06)ng/μmol,IgG/Cr分别为(0．04±0．01)、(0．12±0．05)ng/μmol,差异有统计学意义(P＜0．05)。③尿β2-MG、Alb水平与病理分级呈正相关(r=0．799,P＜0．05),β2-MG/Cr、Alb/Cr水平与病理分级呈正相关(r分别为0．799、0．743,P＜0．01)；尿THP、IgG与病理分级呈正相关,但差异无统计学意义(P＞0．05)；THP/Cr、IgG/ Cr与病理分级呈正相关,差异有统计学意义(P＜0．05)。结论简单易行的输尿管插管留取病肾肾盂尿检测尿蛋白能较准确地反映病肾损害程度,其中尿β2-MG/Cr反映病肾肾小管的损害程度,Alb/Cr反映病肾肾小球的损害程度；尿THP/Cr、IgG/Cr升高分别表明病肾肾小管、肾小球严重受损。
Objective To evaluate the damage degree of diseased kidneys in children with hydronephrosis using urinary β2-microglobulin （β2-MG）,albumin （Alb） , T-H glyeoprotein （THP） and immunoglobulin （IgG）. Methods The β2-MG, Alb, THP and IgC in pelvis urine in diseased kidneys and in healthy kidneys （as controls） were detected in 78 children with congenital hydronephrosis by radioimmunoassay;at the same time urinary ereatinine （Cr） was detected in 36 eases of them. Pathologic changes of the diseased kidneys were graded; and the correlations of pathologic grades with β2-MG, Alb, THP, IgG and β2-MG/Cr, Alb/Cr, THP/Cr, IgG/Cr were analyzed by Spearman＇s test. Results In healthy and hydronephrotie pelvises, the relevant parameters were as follows. （1）Urine β2-MG was （130.06 ± 22.02） ng/ml vs （386.18±42.15） ng/ml; Alb was （80.52 ±9.32）ng/ml vs （275.54±69.46）ng/ml, respectively （ both P 〈 0.05 ）. Urine β2-MG/Cr was （0.16 ± 0.04） ng/μmol vs （ 1.57 ± 0.39 ） ng/μmol ; Alb/Cr was （0.11±0.03）ng/μmol vs （1.07±0.56）ng/μmol （both P 〈0.01）.（2）THP was （25.80±9.02） ng/ml vs （31.43 ± 10.56） ng/ml; and IgG was （15.21±3.56）ng/ml vs （20.52±10.85）ng/ml （P 〉0.05）. THP/Cr was （ 0.05±0.01 ） ng/μmol vs （0.14 ± 0.06 ） ng/μmol ; and IgG/Cr was （ 0.04 ± 0.01 ） ng/μmol vs（0.12 ± 0.05 ） ng/μmol （ P 〈 0.05 ）. （3）There was significant correlation between urine β2-MG, Alb levels and pathologic grades （P 〈0.05）, also between β2-MG/Cr, Alb/Cr levels and pathologic grades（ P 〈 0.01 ）. （4）There was positive correlation between THP, IgG and pathologic grades but with no significance（ P 〉0.05）, also between THP/Cr, IgG/Cr and pathologic grades with significance （P〈0.05）. Conclusions For hydronephrotic kidneys,urine β2-MG/Cr can evaluate the damage degree of nephric tubules, whereas urine Alb/Cr can evaluate that of glomeruli. Increase in THP/Cr and IgG/Cr respectively indicate the impaired nephric tubules and glomeruli in children with congenital hydronephrosis.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2006年第12期817-820,共4页
Chinese Journal of Urology
关键词
肾积水
蛋白尿
病理学
Hydronephrosis
Proteinuria
Pathology
