摘要
目的探讨梗阻性。肾积水患儿尿液中尿血管紧张素原（uAGT）的测定及其与肾功能受损的关系，为肾积水患儿术前评价、术后评判预后提供新的参考指标。方法收集2012年8月至2013年12月在郑州大学第一附属医院小儿外科门诊定期随访或住院接受治疗的单侧先天性肾盂输尿管连接部梗阻肾积水48例患儿的病例资料，分为手术治疗组和定期随访组。手术治疗组28例（均为重度肾积水），均行离断式肾盂成形术。定期随访组20例（均为轻度、中度。肾积水），为确诊肾积水后门诊定期复查，暂无手术指征且肾积水无进行性加重患儿。选择郑州大学第一附属医院同期住院患儿20例为对照组，其中男10例（鞘膜积液患儿），女10例（腹股沟斜疝患儿）。3组间性别构成及年龄比较差异均无统计学意义。收集3组患儿清洁晨尿，手术治疗组术前、术后6周、12周各收集1次；定期随访组和对照组各收集3次，均间隔6周于门诊收集。手术治疗组和定期随访组均行放射性核素检查检测患肾肾小球滤过率（GFR）。采用酶联免疫吸附法（ELISA）测定3组患儿尿中uAGT水平，全自动生化分析仪测定尿肌酐（uCr）水平。结果术前、术后6周和术后12周对照组及定期随访组uAGT／uCr平均水平均显著低于手术治疗组，差异均有统计学意义（F=34．360、14．683、5．035，P均〈0.05）。术前、术后uAGT／uCr与患肾GFR均呈负相关（r=-0．647、-0．786，P均〈0．05）。手术治疗组术前患肾GFR水平为37．18±7．31，术后患肾GFR水平为45．27±8．18，治疗前后比较差异有统计学意义（t=-3．971，P=0．000）。结论uAGT／uCr比值在需要手术治疗的先天性肾盂输尿管连接部梗阻肾积水患儿中明显升高，uAGT升高可能是患儿梗阻性肾积水肾脏功能损伤的指标之一。
Objective To explore the determination of urinary angiotensinogen （uAGT） in the urine of children with obstructive hydronephrosis and its relationship with impaired renal function, to provide a new and rapid reference index for the preoperative evaluation and postoperative follow - up of the children with hydronephrosis. Methods The data were collected from 48 children who were diagnosed as unilateral congenital renal pelvis and ureter obstruction in the outpatient or inpatient Department of Pediatric Surgery of the First Affiliated Hospital of Zhengzhou University,which were divided into operation group and non - operation group. There were 28 children in operation group （who were all severe hydronephrosis） ,who were all operated with dismembered pyeloplasty. There were 20 children in the non - operation group （ who were all mild and moderate hydronephrosis）. They temporarily had no surgery signs and hydronephrosis did not become increasingly serious for assuring the regular outpatient follow - up after being diagnosed as hydronephrosis ;there were 20 children in the control group, 10 of which were male, and 10 female. The males were hospitalized children with hydrocele and the females were with inguinal hernia. Gender composition among the 3 groups, and the average age difference was not statistically significant. The clean urina of children in 3 groups was collected,3 times for operation group, once before operation and once in 6 weeks and once in 12 weeks after operation; 3 times for non - operation group and control group with interval of 6 weeks in outpatient clinic. The children in operation group and non - operation group were all scanned for glomerular fihration rate （GFR） of diseased renal with radionuclide;enzyme- linked immunosorbent assay （ELISA） was adopted to determine the content of uAGT in the urine of the 3 groups of children, and automatic biochemical analyzer was used to measure the amount of urine creatinine （uCr）. Results Before operation,in 6 weeks and 12 weeks after
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2015年第22期1732-1734,共3页
Chinese Journal of Applied Clinical Pediatrics
基金
国家自然科学基金（81172085）
关键词
先天性肾积水
尿血管紧张素原
标志物
肾功能
Congenital hydronephrosis
Urinary angiotensinogen
Marker
Renal function
