尿液蛋白电泳在肾脏疾病中的应用分析

Analysis on application of urine protein electrophoresis in renal diseases

目的探讨非浓缩尿液蛋白电泳在肾脏疾病中的应用价值,以指导调整治疗方案及判断预后。方法回顾性收集徐州市第一人民医院2010年12月至2016年1月152例肾活检患者的临床资料,主要包括病理报告及尿液蛋白电泳结果,根据世界卫生组织（WHO）肾脏病理分级标准进行分级（Ⅰ、Ⅱ、Ⅲ、Ⅳ级）,比较分析肾脏病理分级与尿蛋白电泳分型和电泳图谱中的各成分所占比例的关系。结果肾小球病变率高于肾小管-间质病变率,肾小管-间质病变大部分兼有肾小球病变。尿液蛋白电泳反映肾小球性蛋白尿的水平与肾小球损伤程度相关,并且随着WHO肾脏病理分级（Ⅰ-Ⅳ级）增加,尿蛋白电泳的结合珠蛋白（HAP）和IgG/A所占比例有增加趋势,差异有统计学意义（F=2.237,P〈0.05;F=7.269,P〈0.05）。结论尿蛋白电泳的HAP和IgG/A所占比例检测在反映肾小球损伤程度方面具有重要临床价值。

Objective To explore the application value of non-concentrated urine protein electrophoresis in renal diseases in order to guide to adjust the treatment scheme and judge the prognosis.Methods The clinical data in 152 cases of renal biopsy in the Xuzhou Municipal First People′s Hospital from December 2010 to January 2016 were retrospectively collected,mainly including the pathological report and the results of urine protein electrophoresis.The classification was performed according to the WHO renal pathology classification standard（Ⅰ,Ⅱ,Ⅲ,Ⅳ）.The relationship between the renal pathological classification with the classification of urine protein electrophoresis and the proportions of various compositions in electrophoresis spectrum was comparatively analyzed.Results The glomerular lesion rate was higher than the renal tubules-interstitial lesion rate,the majority of renal tubules-interstitial lesion had combining glomerular lesions.The glomerular urine protein level reflected by the urine protein electrophoresis was associated with glomerular damage degree,with WHO pathological grade（Ⅰ- Ⅳ）increase,the proportion of haptoglobin（HAP）and IgG/A in urine protein electrophoresis showed an increasing trend,the differences were statistically significant（F=2.237,P〈0.05;F=7.269,P〈0.05）.Conclusion Detecting the proportion of HAP and IgG/A in urine protein electrophoresis has an important clinical value in reflecting the glomerular damage severity.