摘要
目的探讨肾病综合征(nephrotic syndrome,NS)患者24 h尿游离轻链(free light chains,FLCs)与其24 h尿蛋白以及病因两者之间的关系,并讨论尿FLCs在NS中的临床意义。方法选择符合NS诊断标准,资料完整的患者共80例。详细记录患者性别、年龄、24 h尿FLCs、24 h尿蛋白、病因、肾穿病理。按24 h FLCs分为FLCs 1组(FLCs>1 000 mg)和FLCs 2组(FLCs≤1 000 mg),用t检验比较两组之间的24 h尿FLCs与24 h尿蛋白之间的关系。并进一步明确两者之间是否具有线性相关性。对于原发性肾病综合征(primary nephroticsyndrome,PNS)病例,再根据24 h FLCs分为FLCs A组(FLCs>1 000 mg)和FLCs B组(FLCs≤1 000 mg),比较两组肾穿病理表现。结果临床资料显示组间发病年龄、性别差异无显著性;当24 h FLCs>1 000 mg时,病例以继发性NS占多数,而FLCs≤1 000 mg时病例则以PNS居多。24 h尿蛋白与24 h尿FLCs之间有正相关,但无线性关系。对于PNS患者,A组出现尿蛋白管型、肾小管上皮变性和间质淋巴细胞浸润的病理表现的比例明显高于B组。结论 NS患者随着24 h尿蛋白增多时,24 h尿FLCs也增加,两者之间成正相关,而明显的尿FLCs增多也可以在临床工作中多考虑继发因素。尿FLCs可以反映肾小管重吸收功能及其损伤程度。
[ Objective ] To analyze the relationship between 24 h-urinary free light chains （FLCs） and 24 h- urinary proteins and the etiopathogenisis in NS patients and detect the clinical significance of urinary FLCs in NS. [Methods] Urine specimens of 80 patients with NS were collected. The levels of 24 h-urinary FLCs and 24 h-uri- nary proteins were examined. The age, gender, etiopathogenisis, and the pathologic characteristics of renal biopsy of all 80 patients were also carefully recorded. On one hand, according to the 24 h-urinary levels of FLCs, these 80 patients were divided into 2 groups： Group FLCsl （FLCs〉I 000 rag） and Group FLCs2 （FLCs ≤ 1 000 rag）. Then the relationship of both groups in 24 h-urinary FLCs and 24 h-urinary proteins was analyzed by t-test. Furthermore, dependability and hierarchical analysis were also done between 24 h-urinary FLCs and 24 h-urinary proteins. The patients with PNS were again divided into 2 groups according to 24 h-urinary levels of FLCs： Group FLCsA （FLCs〉1000 mg） and Group FLCs B （FLCs ≤ 1 000 mg）. [ Results ] No statistical difference of age and gender occurred a- mong different groups of these patients; It is thus suggested that patients with secondary NS may be more than that with PNS in group FLCs2, while majority ones were suffered from PNS when FLCs 1; 24 h-urinary FLCs and 24 h- urinary proteins were positive correlated although without linear dependability. It is indicated by renal biopsy that more cases were with urine protein cast, tubulointerstitial epithelial denaturation and interstitial inflammatory cells infiltration in the FLCsA group. [ Conclusions ] When the level of 24 h-urinary FLCs significantly increased, the level of 24 h-urinary proteins remarkably increased as well, although there was no leaner dependability between the two. And in our clinical practice, secondary NS should be considered much more if the level of 24 h-urinary FLCs strikingly raised. The level of 24 h-urinary FLCs could be used to evaluate the reabsorption function and damage of renal tubule.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2013年第1期90-93,共4页
China Journal of Modern Medicine
关键词
肾病综合征
24
h尿游离轻链
24
h尿蛋白
nephritic syndrome
24 h-urinary free light chains
24 h-urinary proteins
