儿童肾小球疾病尿蛋白组分与其病理类型相关性分析

The correlation analysis of urinary protein electrophoresis and pathologic in children with glomerular diseases

目的探讨儿童不同病理类型肾小球疾病尿蛋白组分的差异及其对疾病诊治的意义。方法 2010年11月至2012年7月郑州大学第一附属医院儿内科收治行肾穿刺活检明确病理类型的肾小球疾病患儿共120例,其中急性肾小球肾炎(AGN)6例,微小病变型肾病(MCD)35例,局灶性阶段性肾小球硬化(FSGS)9例,过敏性紫癜性肾炎(HSPN)44例,IgA肾病(IgAN)17例,溶血尿毒综合征(HUS)9例,全部病例同步行尿蛋白电泳检测,85例同步行尿β2微球蛋白(β2-MG)检测。结果不同病理类型之间比较β2-MG、溶菌酶、视黄醇结合蛋白、游离轻链、α1微球蛋白、轻链二聚体、清蛋白和转铁蛋白所占比例差异显著(P=0.016、P=0.017、P=0.017、P=0.023、P=0.004、P=0.025、P=0.049、P<0.01),小分子蛋白所占比例和尿β2-MG之间相关性良好(r=0.243 P=0.025)。结论尿蛋白电泳和肾组织病理相结合对肾小球疾病的诊治有重要的意义,不同的病理类型有不同的尿蛋白质图谱,尿蛋白质图谱的差异对肾小球疾病发病机制的意义有待进一步研究。

Objective To understand the significance of urinary protein components in children with different pathological types of glomerular diseases,to explore the significance to diagnosis and treatment of disease.Methods Totally 120 children with glomerular diseases,from November 2010 to July 2012 in the First Affiliated Hospital of Zhengzhou University were collected,in which 6children with acute glomerulo nephritis（AGN）,35 children with minimal change disease（MCD）,9children with focal segmental glomerulosclerosis（FSGS）,44 children with Nephritis of Schonlein-Henoch Purpura（HSPN）,17 children with IgA nephropathy（IgAN）and 9children with hemolytic uremic syndrome（HUS）.Urine protein electrophoresis and urineβ2-microglobulin（β2-MG）levels were investigated in different glomerular diseases.Results Significant difference was detected inβ2-microglobulin,lysozyme,retinol-binding protein,free light chain,α1-microglobulin,light chain dimmer,albumin and transferring levels in different glomerular diseases（P=0.016,P=0.017,P=0.017,P=0.023,P=0.004,P=0.025,P=0.049,P〈0.01）.A significant correlation was detected between low molecular weight protein and urineβ2-microglobulin levels（r=0.243,P=0.025）.Conclusion It is significant for diagnosis and treatment of glomerular diseases to the combination of urine protein electrophoresis and renal pathology.Urinary protein profiles are different in different pathological types.Proteomics may be significant for the mechanism of glomerular diseases.