药物干预对IgA肾病患者尿液中结缔组织生长因子水平的影响及临床意义

Effect of Drug Intervention on the Levels of CTGF in Patients with IgA Nephropathy and Its Clinical Significance

目的探讨IgA肾病患者尿液中结缔组织生长因子(CTGF)水平的变化和药物干预对IgA肾病患者尿CTGF水平的影响及临床意义。方法选择IgA肾病病例38例,并应用激素、免疫抑制剂治疗,治疗前后测定患者的尿CTGF水平、尿蛋白/24 h、血浆清蛋白、血肌酐等生化指标,并与尿中CTGF水平进行相关性分析。同时选取在我院体检的非肾病者25例作为对照组。结果 IgA肾病患者治疗前尿中CTGF水平升高,与尿蛋白/24 h、血肌酐水平呈正相关(r分别为0.402、0.373,P<0.05),而与血浆清蛋白水平无明显相关性(r=0.297,P>0.05)。药物治疗后显效、有效组分别在4周、8周尿CTGF出现下降,早于尿蛋白/24 h下降时间。结论检测尿液中CTGF水平对于评价IgA肾病患者的病情及判断激素、免疫抑制剂治疗有效性具有重要的临床意义。

Objective To investigate the changes of level of connective tissue growth factor（CTGF） in the urine of patients with IgA nephropathy,the effect of drug intervention on the levels of CTGF and its clinical significance.Methods 38 patients with IgA nephropathy were treated with steroids and immunosuppressants.The levels of CTGF in the urine,the level of urinary protein,plasma albumin,and serum creatinine were detected before and after treatment.Relevance analysis was performed in accordance with the CTGF level in urine.25 normal controls were selected from outpatients in our hospital.Results The level of CTGF in the urine of patients with IgA nephropathy was increased before treatment.The level of CTGF had a positive correlation with UPQ and serum creatinine（r： 0.402,0.373）,but was not significantly correlated with the level of plasma al-bumin（r = 0.297,P 0.05）.After drug treatment,the level of CTGF of markedly effective group and effective group decreased at 4 weeks and 8 weeks,which was earlier than the decrease of urinary protein.Conclusion The level of CTGF in theurine of patients with IgA nephropathy has important clinical significance in assessing the condition of patients with IgA nephropathy and the effectiveness of hormone and immunosuppressive therapy.