IgA肾病与低相对分子质量尿蛋白的关系

The relationship between IgA nephropathy and low molecular weight urinary protein

目的观察IgA肾病患者尿蛋白相对分子质量与肾小管间质损害及临床指标之间的关系,探讨低相对分子质量尿蛋白在IgA肾病发病机制中的作用。方法采用十二烷基硫酸钠-聚丙烯酰胺凝胶电泳(SDS-PAGE)法检测34例同步行肾活检诊断明确的IgA肾病尿蛋白相对分子质量。结果据SDS-PAGE法,尿蛋白可分为4组类型:小球性尿蛋白组,生理性尿蛋白组,混合性尿蛋白23×103组,混合性尿蛋白10×103组。IgA肾病患者肾小管间质损害评分、24小时尿蛋白定量及血清肌酐(Scr)水平比较,混合性尿蛋白10×103组均较23×103组升高(P<0.05)。结论 SDS-PAGE分型10×103组尿蛋白对判断IgA肾病肾小管间质损害程度有临床意义,其作为无创性检测手段,可以作为判断IgA肾病肾小管间质损害程度的指标。

Objective To investigate the relationship among urinary protein molecular weight of IgA nephropathy,renal tubulointerstitium damage and clinical index,and discuss the role of low molecular weight urinary protein in the mechanism of IgA progression.Methods A total of 34 patients with biopsy proven IgAN were studied.We detect the molecular weight of urinary protein by SDS-PAGE.Data were processed with the classes of tubulointerstitial lesions and laboratory tests such as 24 hurinary protein quantitation and serum creatinine（Scr）.Results The urinary protein were divided into four types according the SDS-PAGE：the ball urinary protein group,physiologic urinary protein group,23×103 proteinuria group and 10×103 proteinuria group.Scores of tubulointerstitial lesions,twenty four hour urine protein quantitation and Scr level were all significantly higher in 10×103 proteinuria group than 23×103 proteinuria group（P〈0.05）.Conclusion 10×103 proteinuria may have close relationship with the progression of IgAN,and it may be a useful index for the degree of tubulointerstitial lesions of IgAN.