成人原发性肾病综合征激素敏感性与肾小管功能的探讨

The relationship between the renal tubular function and the sensitivity of glucocorticoid in the patients of ains

目的：通过测定成人原发性。肾病综合征（AINS）患者的UOSM、尿β2-MG，探讨肾小管功能与激素敏感性之间的关系。方法：采用前瞻性研究将68例AINS患者根据治疗前UOSM和尿β2-MG所测数据分为4组并给予激素治疗，通过比较各组治疗前后UOSM和尿β2-MG的变化探讨对激素的敏感性。结果：1．肾小管间质病变有随蛋白尿时间延长而加重的趋势。2．B组患者治疗后尿β2-MG降低（P〈0．05），UOSM无变化（P〉0．05）；C组患者治疗后UOSM升高（P〈0．05），尿β2-MG无变化（P〉0．05）；A组、D组两项数据治疗前后均无差异（P〉0．05）。3．A、B、C组的完全缓解率高于D组（P〈0．05），UOSM降低、尿β2-MG升高是激素不敏感的危险因素。结论：UOSM、尿β2-MG数据可作为预测AINS患者对激素是否敏感的依据，且UOSM优于尿β2-MG。

Objective zTo investigate the relationship between the renal tubular function and the sensitivity of glucoconicoid in adult patients with idiopathic nephrotic syndrome. Methods ： In a prospective study, sixty - eight patients of AINS were divided into four groups by urinary beta 2 - microglobulin and urinary, osmolality determined before curing. And the two indexes were compared before and after therapy. Results： 1, Tubulointerstitial lesions would be from bad to worse. 2, Urinary beta 2 - microglobulin was decreased significantly in B group, urinary osmolality was increased significantly in C group （ P 〈 0. 05 ） . The two indexes were no differences in A, D group （ P 〉 0.05 ）. 3, The rate of fully remission in A, B, C group is higher than D group （ P 〈 0. 05 ）. Conclusions： Determination of UOSM and urinary β2 - MG may predict the sensibility of the therapy in adult patients with initially nephrotic syndrome, and UOSM is better.