原发性肾病综合征肾小管功能异常与肾小管间质病理损害的相关性分析

Relationship between tubular dysfunctions and tubulointerstitial lesions in patients with idiopathic nephrotic syndrome

目的：探讨原发性肾病综合征（NS）患者临床肾小管功能异常与肾小管间质病理损害的相关性。方法：回顾性分析2006年5月2008年9月确诊并行肾穿刺活检的原发性NS患者82例，观察肾小管间质病理改变，并进行半定量评分；同时测定患者肾小管功能损害指标——尿视黄醇结合蛋白（RBP）、尿α1微球蛋白（α1-MG）、N-乙酰-β-D-尿氨基葡萄糖苷酶（NAG）水平，观察肾小管功能异常与肾小管间质病理损害的相关性。结果：不同病理类型的原发性NS患者肾小管间质病理损害程度及尿RBP、α1-MG、NAG水平均不同（P〈0．05）；肾小管间质病理损害重的患者尿RBP、α1-MG、NAG明显增高（P〈0．05）。结论：原发性NS患者肾小管功能异常与肾小管间质病理损害密切相关，肾小管功能测定能在一定程度上评价患者肾小管间质病理损伤程度。

Objective： To investigate the relationship between tubular dysfunctions and tubulointerstitial lesions in patients with idiopathic nephrotic syndrome（NS）. Methods ：The pathological changes of 82 patients with idiopathic NS and the biochemical tests about renal tubular functions, retinol-binding protein （RBP）,α1-Microglobulin （α1-MG）and N-Acetyl-beta-D-Glucosaminidase （NAG）, were investigated. Results ： The degree of tubular dysfunctions and levels of urine RBP,α1-MG and NAG differed between different forms of glomerular diseases （P〈0.05）. Patients with more severe tubulointerstitial lesions presented with higher RBP ,α1-MG and NAG levels （P〈0.05）. Conclusion： Tubular dysfunctions are closely correlated with tubulointerstitial lesions. Urine RBP,α1-MG and NAG can serve as biochemical markers for tubulointerstitial lesions.