54例膜性肾病尿蛋白谱与临床病理指标相关性分析.docVIP

54例膜性肾病尿蛋白谱与临床病理指标相关性分析 　　[摘要] 目的 探讨膜性肾病患者尿中白蛋白（Alb）、转铁蛋白（TRF）、免疫球蛋白（IgG）、β2-微球蛋白（β2-MG）、α1微球蛋白（α1-MG）与临床及病理指标的关系。方法 用散射比浊法检测入院后治疗膜性肾病的54例患者次日新鲜晨尿液中Alb、TRF、IgG、α1-MG、β2-MG的浓度；收集患者血压、年龄、性别、血肌酐以及病理分期、肾小管间质损害积分进行对比分析。结果 54例膜性肾病患者病理分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期病例数各占25.9%、51.9%、14.8%、7.4%；男性发病年龄显著高于女性；尿中Alb、TRF、IgG、α1 -MG、β2-MG升高的比例分别为100%、100%、100%、94%、85%；血压升高组较血压正常组尿IgG、α1-MG、β2-MG明显升高；肾功能异常组较肾功能正常组尿IgG、β2-MG 、TRF明显升高；随病理分期、肾小管间质损害积分的增加尿中TRF、IgG、β2-MG的浓度亦明显升高。结论 膜性肾病患者尿Alb、TRF、IgG、α1-MG、β2-MG的浓度检测可以作为膜性肾病病理改变的参考观察指标，能更全面地反映膜性肾病的病变程度，有助于判断预后、指导治疗，在临床实践中有一定的应用价值。 　　[关键词]尿蛋白谱； 膜性肾病 ；病理 　　[中图分类号] R692.3 [文献标识码] A [文章编号] 1673-9701（2011） 23-01-03 　　 　　The Correlation between Urine Protein Sectrum and Clinical Pathological Factors in Patients with Membranous Nephropathy： An Analysis of 54 Cases 　　CHEN Jiansheng1 YE Ruiyin1 CHEN Fadong2 LIN Maoen1 LUO Tong1 MA Zhiquan2 　　1.Department Nephrology，Ruian Municipal Hospital of Traditional Chinese Medicine Hospital in Zhejiang Province, Department Nephrology，Ruian 325200, China；2.Ruian Municipal People’s Hospital in Zhejiang Province, Ruian 325200, China 　　 　　[Abstract] Objective To evaluate the diagnostic value of urine protein spectrum by analyzing the correlation between clinical-pathological factors in patients with membranous nephropathy and urine protein spectrum,such as albumin（Alb）,transferrin（TRF）, immunoglobulins（IgG）, β2-microglobulin（β2-MG）,α1-microglobulin （α1-MG）. Methods There were 54 newly diagnosed patients with membranous nephropathy in this series.At the first day after admission, the fresh morning urine was collected to test concentration of Alb, TRF, IgG, β1-MG, α2-MG by nephelometry；data of blood pressure, age, gender, serum creatinine, pathological stage, and tubulointerstitial damage score were collected and analyzed statistically. Results In 54 patients with membranous nephropathy，the prevalence of pathological stageⅠ,Ⅱ,Ⅲ,Ⅳ were 25.9%，51.9%，14.8%，7.4%，respectively；age of onset in male was significantly higher than f