慢性肾病患者肾功能评价指标与肾小球硬化关系研究

The Pelationship between Evaluation Indicators of Renal Function and Glomerular Sclerosis in Patients with Chronic Kidney Disease

目的:分析几种常见的肾脏功能指标分别与肾小球硬化的相关性,探讨几种常见的肾脏功能指标对预测慢性肾病患者肾小球硬化程度的价值。方法:选择2007年9月至2008年3月期间在中南大学湘雅二医院肾病内科住院的95例慢性肾脏病患者。收集所有患者的一般资料及实验室检查资料,其中肾脏功能评价指标包括据改良的简化MDRD公式估算的eGFR、血清β2微球蛋白(β2-MG)、血清肌酐(Scr)。95例患者均于住院期间行肾脏穿刺活检术并确诊为原发性肾小球肾炎,取患者肾组织,光镜下定量测量出每例患者肾小球硬化相对面积[肾小球毛细血管襻硬化面积占肾小球毛细血管襻总面积的百分比(Rg)]。将各肾功能指标与肾小球硬化相对面积进行相关性分析。结果:eGFR与Rg均存在高度负相关关系;β2-MG、Scr与Rg均存在正相关关系。结论:原发性肾小球肾炎所致CKD患者的肾脏功能改变与肾脏病理肾小球硬化程度具平行关系。肾功能指标改变eGFR、β2-MG、Scr均可用以预测肾脏病理肾小球硬化程度,其相关系数依次由高到低。

Objective:To assess the value of several common kidney function indexes for the prediction of the glomerular Sclerosis in patients with chronic kidney disease by studying the correlation between those kidney function indexes and degree ofglomerular sclerosis,aiming to explore guidance for clinic treatment and prognosis judgement.Methods:We have chosen 95 patients those who were hospitalized from September 2007 to March 2008 in Department of Nephrology of 2nd XiangYa Hospital of Central South University.We collected data of all patients with general information and laboratory. Collection of the renal function ranged as follows:eGFR which were estimated from the improved simplified MDRD equation、serumβ2-MG(β2-MG)、serum creatinine(Scr).95 patients were all be diagnosed as primary kidney disease through a kidney biopsy,got kidney tissues from biopsy, quantitatively measured the relative areas of glomerular sclerosis(the area of glomerular sclerosis/the total area ofglomerular capillary loop×100%) of each patient under the light microscope.To analyze the correlation between those clinical indexes and the degree ofglomerular sclerosis.Results:eGFR and Rg were all highly negatively correlated;There were positive correlations betweenβ2-MG and RgScr and Rg.Conclusions:There was parallel relationship beween kidney function changes and glomerular Sclerosis progression in the CKD patients which was caused by primary kidney disease,eGFR、β2- MG、Scr can all be used to assess the the degree of the glomerular sclerosis,the correlation indexes were decreased in turn.