尿RBP、β_2-MG、NAG对原发性肾病综合征患儿激素治疗敏感性的预测意义

The Predictive Value of Urinary RBP,NAG and β_2-MG for Glucocorticoid Hormone Therapy Sensibility of Children with Primary Nephrotic Syndrome

目的通过测定原发性肾病综合征患儿尿视黄醇结合蛋白(RBP)、β2-微量球蛋白(β2-MG)和N-乙酰-β-D氨基葡萄糖苷酶(NAG),了解肾病综合征患儿肾小管功能与激素治疗效果之间的关系。方法测定60例小儿原发性肾病综合征患儿治疗前和激素治疗8周后尿RBP、β2-MG和NAG含量,根据治疗后尿蛋白水平将患儿分为完全效应、部分效应和无效应3组,比较各组间治疗前、后肾小管功能指标变化。结果治疗前3组患者尿RBP、NAG、β2-MG和蛋白质含量间差别均无显著性意义(P>0.05)。治疗后3组患儿RBP、β2-MG、NAG的含量间差别均有显著性意义(P<0.05);部分效应组与无效应组RBP、β2-MG、NAG含量间差别有显著性意义(P<0.05);完全效应组与无效应组RBP、β2-MG和NAG含量间差别亦有显著性意义(P<0.05)。结论尿RBP可预测原发性肾病综合征患儿激素治疗的敏感度,且效果优于β2-MG和NAG。

Objective To study the relationship between the renal tubular function and the efficacy of glucocorticoid by determining urinary RBP, NAG and 132 -MG concentrations in child patients with primary nephrotic syndrome. Methods Pro - and post - therapy urinary RBP, NAG and 132 - MG were determined double antibodies sandwich ELISA and color comparimetry, respectively. Sixty child patients with primary nephritic syndrome, according to the concentrations of urinary protein, were divided into three groups, no efficacy group, partial efficacy group and fully efficacy group, forty normal children as the control group. The renal tubular function parameters among groups were compared before and after therapy. The results were used to predict the sensibility of glucocorticoid therapy. Results （ 1 ） There were no significant differences in urinary RBP, NAG, β2 - MG and protein levels before treatment among patient groups （ P 〉 0. 05 ） ; （ 2 ） There were decreases in urinary RBP, NAG and β2 - MG following glucocorticoid therapy in those response to glucocorticoid （ P 〈 0. 05 ） ： （ 3 ） RBP, β2 - MG level had significant decrease among the efficacy groups of patients with primary nephrotic syndrome after treatment （ P 〈0. 05 ）. Conclusion The determination of urinary RBP may predict the sensibility of the therapy in the childhood patients with primary nephrotic syndrome and its diagnostic efficiency is better than that of urinary NAG and β2 - MG.