过敏性紫癜性肾炎患儿肾小管功能检测

Clinical significance of detecting renal tubule function in children with anaphylactoid purpura nephritis

目的:探讨尿视黄醇结合蛋白(RBP)、尿胱蛋白酶抑制剂C(CysC)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)的测定在判断小儿过敏性紫癜性肾炎(APN)肾小管-间质损伤中的临床意义。方法:用ELISA方法和酶-底物直接显色法测定24例APN患儿(肾穿报告提示急性病变10例,急性+慢性病变10例,另4例未见肾小管间质病变)尿液中RBP、CysC、NAG的含量,分析3者的相关性以及与肾小管-病理损伤的关系。结果:急性病变患儿与急性+慢性病变患儿RBP、CysC、NAG含量差异无统计学意义。24例患者中尿RBP/Cr和CysC/Cr异常百分率分别为58.3%(14/24)、50.0%(12/24),且两者有相关性(r=0.877,P<0.0001)。尿NAG的异常百分率为75.0%(18/24),与前两者无关。RBP、CysC、NAG在不同肾小球病理分级中差异均有统计学意义。结论:尿RBP、CysC、NAG3者联合检测对早期诊断和全面监测肾小管-间质损伤具有重要的临床意义。

Aim： To study the clinical significance of determining of retinol binding protein （RBP） , Cystain C （ CysC） , N-acetyl-β-D-glucosa minidase （NAG） in children with anaphylactoid purpura nephritis （APN）. Methods： The renal tubules functions （RBP, CysC, NAG in urine） were detected using ELISA and biochemistry assay in 24 children with APN ,which included 10 cases of acute pathological lesion, 10 cases of acute plus chronic pathological change according to the results of kidney puncture. The co-relationship between the above indexes and the relationship of these indexes with the renal tubular interstitial injury were analyzed. Results： The three indexes had no statistical difference between acute pathological lesion and acute plus chronic pathological lesion. The excretion of RBP was correlated with that o,f CysC （ r = 0. 877, P 〈 0. 000 1 ） , but neither of them was correlated with that of NAG. Conclusion： The determination of RBP, CysC, and NAG in urine has significance in early diagnosing and estimating the degree of renal tubular interstitial lesion.