返流性肾病尿微量蛋白变化与肾损害的关系

Association of urinary protein change in reflux nephropathy patients with renal damage

目的 :了解返流性肾病尿微量蛋白变化与肾损害的关系。方法 :用放射免疫法对确诊为返流性肾病病儿尿β2 微球蛋白 ( β2 -M)、白蛋白 (Alb)及免疫球蛋白G (IgG)、Tamm -Horsfall蛋白(THP)等 4项蛋白进行检测。结果 :尿β2 -M、Alb、IgG在返流性肾病的患儿均较正常组增高。重度膀胱输尿管返流的返流性肾病病儿尿THP明显降低 ,而轻度者尿THP未见降低。结论 :返流性肾病病儿除肾小管损害外 ,亦累及肾小球 ,同时检测尿 β2 -M、THP能更好地反映肾小管功能 ,若结合Alb、IgG测定则更能了解返流性肾病的严重程度 ,有助于对预后的判断。

Aim: To investigate the association of urinary protein change in reflux nepropathy patients with renal damage. Methods: Using radioimmunassay to measured the urinary β 2-microglobulin, albumin, immunoglobulin G and Tamm-Horsfall protein excretion in reflux nepropathy children. Results: The urinary β 2-microglobulin, albumin and immunoglobin G excretion in reflux nephroathy patients are significantly higher than those in normals. The urinary Tamm-Horsfall protein excretion in patients with severe degree of vesicoureteric reflux are significantly lower than those in normals , but those, in patients with milder degree of vesicoureteric reflux are normal. Conclusion: Reflux nephropathy may lead to glomerular damage beside tubular damage; measure the urinary β 2-microglobulin, albumin, immunoglobulin G and Tamm-Horsfall protein exeretion in the same time, maybe a more valuable tool in diagnosis the degree of renal damage of the patients with reflux nephropathy.[