伴高尿酸血症IgA肾病患者肾小管相关指标的变化

Changes of renal tubular related indexes in IgA nephropathy combined with hyperuricemia

目的探讨伴高尿酸血症Ig A肾病患者肾小管相关指标的变化情况,以了解高尿酸对肾小管的影响。方法选取2014年2月~2016年1月就诊于潍坊市益都中心医院的105例原发性Ig A肾病患者作为研究对象,依据血尿酸水平分为正常尿酸组(n=55)及高尿酸组(n=50)。观察两组患者的尿β2微球蛋白(β2-MG)、N-乙酰-β-D氨基葡萄糖苷酶(NAG)、视黄醇结合蛋白(RBP)、尿可滴定酸(TA)、尿铵离子(NH4+)、尿渗透压(UOSM)的变化。结果高尿酸组患者尿β2-MG、RBP、NAG均高于正常尿酸组,差异有统计学意义(P<0.01);两组的尿TA、NH4+、UOSM比较差异无统计学意义(P>0.05)。结论高尿酸血症对Ig A肾病患者近端肾小管有明显的损伤,而对远端肾小管的酸化及浓缩稀释功能的影响较小。

Objective To investigate the changes of renal tubular related index in patients with hyperuricemia IgA nephropathy,and understand the impact of high uric acid on renal tubules.Methods A total of 105 patients with primary IgA nephropathy treated in Yidu Central Hospital of Weifang from February 2014 to January 2016 were selected as the subjects,and divided into normal uric acid group(n=55)and hyperuricemia group(n=50).The urinaryβ2-microglobulin(β2-MG),N-acetyl-β-D-glucosaminidase(NAG),Retinol-binding protein(RBP),titratable acid(TA),urinary ammonium ion(NH4+),urine osmotic pressure(UOSM)were observed.Results The urinaryβ2-MG,RBP and NAG in high uric acid group were significantly higher than those in normal uric acid group,the difference was statistically significant(P<0.01).There was no significant difference in urine TA,NH4+and UOSM between the two groups(P>0.05).Conclusion Hyperuricemia has obvious damage to the proximal tubules of patients with IgA nephropathy,but it has little effect on the acidification and concentration and dilution of distal tubules.