糖皮质激素对肾小球滤过膜通透性的影响

The Effects of Steroids on Glomerular Permeability

通过对15例难治性肾病综合征使用激素前后对照研究,发现激素可以加重蛋白尿。使用激素后小分子蛋白构成比显著下降,中分子无显著变化,大分子显著增多;定量分析显示尿β_2微球蛋白和小分子蛋白排泄量无显著变化,大、中分子蛋白排泄量显著增加。对不同分子量尿蛋白排泄量增加的程度进行比较发现,大分子蛋白增加的程度>中分子>小分子。提示大剂量使用激素加重蛋白尿的机制之一是激素使肾小球滤过膜对分子量较大蛋白质的屏障功能下降通透性增加。

Fifteen refractory nephrotic patients were studied before and after prednison administration. Significant increase in urine protein with the more increment in larger molecular protein excretion was observed. There was no significant change in β2 microglobulin excretion. In conclusion,steroids had an ac-celerative effect on the glomerular permeability.