儿童肾小球疾病尿蛋白电泳测定及其病理分析

Urine protein electrophoresis and its pathological analysis of glomerular diseases in children

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对疾病诊治的意义。方法选择2011年11月至2014年7月收治的患儿共240例，所有患儿均行肾穿刺活检明确病理类型，其中急性肾小球肾炎（AGN）12例，微小病变型肾病（MCD）70例，局灶性阶段性肾小球硬化（FSGS）18例，过敏性紫癜性肾炎（HSPN）88例，IgA肾病（IgAN）34例，溶血尿毒综合征（HUS）18例，全部患儿同步行尿蛋白电泳及尿β2微球蛋白（β2-MG）检测。结果不同病理类型间β2微球蛋白、溶菌酶、视黄醇结合蛋白、游离轻链、α1微球蛋白、轻链二聚体、白蛋白和转铁蛋白比较差异有统计学意义（P 均﹤0.01），小分子蛋白所占比例和尿β2微球蛋白间相关性良好（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具有重要的意义，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 investigate the significance of the difference of urinary protein compo-nents in children with different pathological types of glomerular diseases. Methods Two hundred and forty children from November 2011 to July 2014 were selected,they all had pcrcutaneous renal puncture and explicit pathological type,12 children with acute glomerulo nephritis（AGN）,70 children with mini-mal change disease（ MCD）,18 children with focal segmental glomerulosclerosis（ FSGS）,88 children with nephritis of Schonlein-Henoch purpura nephritis（HSPN）,34 children with IgA nephropathy（IgAN） and 18 children with hemolytic uremic syndrome（HUS）. Urine protein electrophoresis and urine β2-mi-croglobulin（β2-MG）levels were detected in different glomerular diseases. Results Significant difference was detected in β2-microglobulin,lysozyme,retinol-binding protein,free light chain,α1-microglobulin, light chain dimmer,albumin and transferring levels in different glomerular diseases（all P ﹤ 0. 01）. There was correlation of low molecular weight protein with urine β2-microglobulin levels（ r = 0. 243,P =0. 025）. Conclusions It is significant for diagnosis and treatment of glomerular diseases that the combi-nation of urine protein electrophoresis and renal pathology. Urinary protein profiles are different in differ-ent pathological types. Proteomics may be significant for the mechanism of glomerular disease.