原发性肾病综合征患儿血尿酸水平及其影响因素分析

Serum Uric Acid Level and Its Influencing Factors in Children with Primary Nephrotic Syndrome

目的分析原发性肾病综合征(PNS)患儿血尿酸水平与各尿酸排泄指标的相关性,探讨PNS患儿高尿酸血症患病的可能机制。方法回顾性分析74例PNS患儿的临床资料,比较合并高尿酸血症组(HUA组)与尿酸正常组(NUA组)患儿年龄、血尿酸、肌酐、尿素、胱抑素C、血甘油三酯、血胆固醇、血白蛋白、肌酐清除率、24 h尿尿酸、血尿酸/血肌酐、尿酸清除率、尿酸排泄分数等指标的差异,并对尿酸排泄指标进行相关性分析。结果 HUA组血白蛋白、尿酸排泄分数较NUA组低(P分别为0.034),而HUA组血胱抑素C、血尿酸/血肌酐比值较NUA组高(P分别为0.038、0.001);PNS患儿尿酸排泄分数与血尿酸水平呈负相关(r=-0.43,P=0.016),血尿酸/血肌酐比值与血尿酸呈正相关(r=0.486,P=0.001)。结论 PNS可引起血尿酸生成增多及排泄减少;血尿酸水平与肾小管功能密切相关。

Objective To explore the correlation between serum uric acid levels and uric acid excretion indexes in children with primary nephrot- ic syndrome （PNS）, and to reveal the prevalence of hypenLricemia and its possible causes in PNS. Methods The clinical data in 74 cases of pe- diatric PNS were retrospectively analyzed. These patients were grouped as hypemric acid （HUA） or non-hypemric acid （NUA）, and their clinical features and laboratory findings were compared between two groups, including age, serum uric acid, serum creatinine, urea, cystatin C, triglycer- ide, cholesterol, albumin, creatinine clearance rate, 24 hours urine uric acid, serum uric acid / serum creatinine, uric acid clearance, and the frac- tional excretion of uric acid and other indicators of differences. In addition, a correlation analysis was carried out for the excretion of uric acid index. Results Several factors were lower in HUA group than that of NUA group, such as the serum albumin and fractional excretion of uric acid （PI = 0.034, P2 = 0.025） ;while the serum cystatin C and serum uric acid/serum creatinine ratio （P1 = 0.038, P2 = 0.001 ）was higher in HUA group. The uric acid excretion was negatively correlated with serum uric acid levels in all 74 children with PNS （r = -0.43, P = 0.016）, and the serum uric acid / cmatinine ratio was positively correlated with serum uric acid （r = 0.486, P = 0.001 ）. Conclusion Both the increase of blood uric acid production and excretion reduction were observed in children with PNS, and the serum uric acid levels and renal tubular function is closely related.