摘要
目的了解早期紫癜性肾炎(HSPN)患儿尿微量蛋白与不同临床类型的肾小管间质病理改变的关系。方法将41例我院肾活检证实为HSPN的患儿,按不同临床类型、病理分型、肾小管-间质病理改变分组,并对各组微量蛋白(β2-MG、THP、IgG、Alb)进行比较。结果HSPN表现孤立性血尿或蛋白尿7例(17.07%),血尿及蛋白尿11例(26.83%),急性肾炎型7例(17.07%),肾病综合征型16例(39.02%),所有病例伴有蛋白尿时IgG和Alb增高更明显。其中肾病综合征型有β2-MG、THP的显著异常;肾活检肾小球病理类型Ⅱ级19例(46.34%),Ⅲ级15例(36.59%),Ⅵ级7例(17.07%),肾小球病理类型的加重伴随间质损伤的加重(χ2=23.33,P<0.01),以及β2-MG、THP的明显增高(均P<0.05)。结论尿微量蛋白能反映HSPN各种临床及病理类型随肾小球病理损害的加重而小管间质病变加重,尿微量蛋白的排泄程度增加,可作为判断HSPN的病理损伤的严重程度指标之一。
Objective To investigate the relationship between urine trace proteins and tubulointerstital lesions in all kinds of clinical and pathological types for Henoch-Schoenlein nephritis（HSPN）. Methods Fourty-one cases with HSPN were studied. They were divided into three groups according to clinical pathological types and tubulointerstital changes, and the levels for four urine trace proteins（β2-MG,THP,IgG,Alb）were analyzed. Results There were 7 patients with isolation hematuria or proteinuria, 11 patients with hematuria and proteinuria, 7 patients with acute nephritis and 16 patients with nephritical syndrome. It showed that the levels for IgG, Alb were significantly different in child with proteinuria compared with the other two groups without proteinuria. The levels of low-molecular protein such as β2-MG, THP were the highest in four groups. The majority had pathological changes of Grade Ⅱ （46.34%）, Ⅲ （36.59%）, Ⅵ （17.07%）of glomerulus classification. On the other hand, the tendency showed that the higher the pathological changes the more serious the tubulointerstital lesions, along with the increased value of β2-MG and THP. Conclusion The urine trace protein can reflect that the pathologic change of renal tubule is parallel and correlated with the pathologic morphology change of glomerulus,and the level increases in all kinds of clinical and patholcgical types for HSPN. The change of urine trace protein can be used to judge the degree of tubulointerstital lesions.
出处
《重庆医学》
CAS
CSCD
2005年第12期1820-1822,共3页
Chongqing medicine
关键词
紫癜性肾炎
临床
病理
儿童
尿微量蛋白
Henoch-Schoenlein purpura
nephritis
tubulointerstitial
child
urine trace protein
clinic
pathology
