尿液生物标记物在儿童肾病综合征中的研究进展

Research progress in urinary biomarkers for the diagnosis and treatment of children nephrotic syndrome

肾病综合征(NS)是一组由多种原因引起的肾小球基底通透性增加,导致血浆内大量蛋白质从尿中丢失的临床综合征。临床上有大量蛋白尿、低蛋白血症、高脂血症和明显水肿四大特点,其中以大量蛋白尿和低蛋白血症为必备条件。NS按病因可分为原发性、继发性和先天性三类。原发性肾病综合征(PNS)约占儿童时期NS总数的90%。目前肾活检仍然是对PNS诊断和分类的金标准,肾活检本质上是有创性的检查,存在潜在的并发症等风险,且临床上为了监控疾病进展,必要时需要重复进行肾活检,这使得该项检查在患儿及其家长中难以接受。为了更好地诊断疾病,指导临床治疗,迫切需要可靠的无创性生物标志物来准确诊断儿童PNS。该文将对尿液中生物标记物在PNS中的临床意义进行综述。

Nephrotic syndrome(NS) is a group of clinical syndromes caused by increased glomerular basement permeability for various causes, resulting in the loss of large quantities of protein from the urine. Clinical features are as follows: massive albuminuria, hypoproteinemia, hyperlipidemia and edema, and massive albuminuria and hypoproteinemia are the necessary conditions. According to the etiology, NS can be divided into 3 types: primary, secondary and congenital. PNS accounts for about 90% of childhood NS. Renal biopsy is still the gold standard for the diagnosis and classification of PNS. Renal biopsy is essentially a invasive examination, and there is a potential risk of complications. Repeated renal biopsy is needed in necessity to monitor the progression of the disease, which makes this examination difficult to accept by children and their parents. In order to better diagnose the disease and guide the clinical treatment, there is an urgent need for a reliable noninvasive biomarker to diagnose the children’s PNS accurately. This article reviewed the clinical significance of urinary biomarkers in PNS.