肾小管标志物测定在原发性肾病综合征治疗前后的意义

The Significance of Determination of Renal Tubular Markers Before and After Treatment in the Primary Nephrotic Syndrome

目的:通过测定肾小管标志物判断原发性肾病综合征(PNS)病人的肾小管受损程度,以期探讨在不同疗效的病人治疗前后的意义。方法:应用放射免疫分析测定白介素-6(IL-6)、内皮素-1(ET-1)、α1-微球蛋白(α1-m)、β2-微球蛋白(β2-m);用ELISA测定纤维蛋白原降解产物(FDP);速率法测定N-乙酰β-D氨基葡萄糖苷酶(NAG);物理法测定纯水清除率(CH2O)。结果:在安全缓解的病例中IL-6、ET-1、α1-m、β2-m、FDP、NAG多种肾小管标志物经治疗后均下降(P<0.01),而CH2O没有明显改变(P>0.05);在无效组中IL-6、ET-1、α1-m、FDP下降不明显(P>0.05);部分缓解和无效组中的肾小管标志物结果均比完全缓解和显著缓解的结果为高。结论:通过监测多种肾小管标志物可起到诊断和监测,以及判断肾病综合征病人的疗效,对治疗起指导作用。

Objective To evaluate the damage of renal tubule of patients with primary nephrotic syndrome（PNS） by detecting renal tubule markers and investigate the significance of different therapeutic effects.Methods Serum levels of interleukin-6（IL-6）,ET-1,α1-microglobulin（α1-m）,β2-microglobulin（β2-m） and plasma level of ET-1 were determined with RIA,fibrinogen degradation product（FDP） with ELISA,automatic biochemistry anaysis N-acetyl-β-D-glucosaminidase（NAG）,CH2O was determined with physico-method respectively.Results The concentrations of IL-6,ET-1,α1-m,β2-m,FDP,NAG were significantly decreased in cases of complete remission after therapy（P0.01）,but CH2O excepted（P0.05）,the decrease of IL-6,ET-1,α1-m,FDP were no significant in cases of invalid（P0.05）,the concentrations of renal tubule markers in cases of partial remission and invalid were higher than those in cases of complete and significant remission.Conclusion The determination of several renal tubule markers can be used for diagnose,monitor and judge the therapeutic effects of PNS.