测定血清透明质酸、层粘蛋白等对肾纤维化诊断的意义

Significance of serum hyaluronic acid,larninin and other levels in the diagnosis of renal fibrosis

目的探讨血清透明质酸、血清层粘蛋白、血清Ⅲ型前胶原和血清Ⅳ型胶原测定对肾纤维化实验研究及诊断的价值。方法采用腺嘌呤制作大鼠慢性肾功能衰竭模型,将其分为正常对照组、模型组,测量两组血清透明质酸、血清层粘蛋白、血清Ⅲ型前胶原、血清Ⅳ型胶原、尿素氮和血肌酐水平,并对大鼠肾脏组织进行病理观察。结果大鼠慢性肾功能衰竭模型组大鼠血清尿素氮、血肌酐水平较对照组明显升高(P<0.01);血清透明质酸水平较对照组明显升高(P<0.01),且与肾纤维化程度呈正相关关系;血清层粘蛋白、血清Ⅲ型前胶原、血清Ⅳ型胶原水平较对照组差异无统计学意义。病理结果表明,对照组大鼠肾脏组织大致,模型组大鼠肾组织病理损伤严重。结论血清透明质酸等检测可较好地反映糖尿病肾病肾纤维化程度,在肾纤维化的诊治及预后方面能够提供一定的参考价值,可作为早期预测肾纤维化的实验室无创性检测指标之一。

Objective To study the experimental research and the diagnostic value of serum hyaluronic acid （HA）, serum laminin, serum procollagen type Ⅲ and serum type IV collagen levels in renal fibrosis. Methods Rat models with chronic renal failure produced by adenine. These models were divided into normal group and model group. Measured levels of HA, serum laminin, serum procollagen type Ⅲ and serum type Ⅳ collagen, blood urea nitrogen and serum creatinine liver. Observed pathological changes of kidney. Results The serum levels of blood urea nitrogen （P 〈0.01）, serum creatinine liver, HA increased in chronic renal failure model group （P 〈0.01）, and HA positively correlated with renal fibrosis. In both groups, no significant differences among serum laminin, serum procollagen type Ⅲ and serum type IV collagen. Path ological results showed that the control rats had generally normal kidney tissue and the renals have serious pathologic injury in model group. Conclusion HA, etc level detection may well reflect the degree of diabetic renal fibrosis. It can be able to provide some reference value in the treatment and prognosis of renal fibrosis, and it can be used as a laboratory indicator of non-invasive testing in early prediction of renal fibrosis.