酮酸疗法对狼疮性肾炎尿蛋白水平的影响

Influence of ketoacid therapy on the quantity of protein in the uria of lupus nephritis

目的研究酮酸疗法对狼疮性肾炎(LN)尿蛋白水平的影响。方法选择门诊和住院的LN及非狼疮性慢性肾功能不全(NLN)患者共69例,所选患者血清尿素氮(BUN)均>9 mmol/L,血清肌酐(CRE)>178μmol/L,且无肝脏酶学异常。将LN与NLN病人随机分2组:实验组为极低蛋白饮食+α-酮酸治疗组,对照组为单纯低蛋白饮食治疗组,所有LN或NLN患者其他治疗均相同,在治疗前及治疗后2周、2月分别留取患者晨起第一次尿,混匀离心后留取上清,置于-30℃冻存,待批量检测,用酶标法定量测定尿微量白蛋白(ALB)、转铁蛋白(TRF)、IgG水平。结果酮酸疗法治疗2月后:LN组尿ALB、TRF、IgG水平明显下降,实验组较对照组下降明显,但二者比较无统计学意义(P>0.05);NLN组尿ALB、TRF、IgG水平下降,实验组较对照组下降明显,但二者比较无统计学意义(P>0.05)。结论LN肾功能不全时蛋白尿为非选择性的,酮酸疗法对减少LN及非狼疮性CRF蛋白尿起一定作用。

Objective To gain clear idea of the influence of ketoacid therapy on the quantity of protein in the uria of lupus nephritis（LN）. Methods Sixty - nine patients suffered from LN or chronic renal failure（CRY） caused by other reasons were chosen from the outpatients and inpatients department,the serum urea nitrogen（BUN） and serum creatinine（CRE） of all patients were higher than 9 mmol/L and 178 μmol/L respectively,serum enzyme were nomnal. These patients of LN and NLN were randomly divided into two groups： the investigating group accepted very low protein diet and ketosterile;the control groups accepted simple low protein diet, all the other treatments were same. The patient＇s fast urine as sampled for following tests：Urine quantitative test of ALB,TRF and IgG were detected by enzyme linked immunosorbent assay. Results After two months of ketoacid therapy ,the quantity of protein in the uria of LN decreased obviously ,and that of the investigating group of LN and NLN declined obviously than that of control group,however it was not significant. Conclusion LN with renal failure has non - seletive proteinuria and ketoacid therapy can decrease the quantity of protein in the uria of LN and NLN.