血清和尿Ⅳ型胶原、层粘连蛋白、Ⅲ型胶原测定在高血压性肾损害中的意义

Significance of detecting serum and urine type Ⅳ collagen,laminin and type Ⅲ collagen for hypertensive kidney lesion

目的 观察高血压病患者血清和尿中Ⅳ型胶原 (C Ⅳ )、层粘连蛋白 (LN )、Ⅲ型胶原(C Ⅲ )水平变化及与尿白蛋白、β2 微球蛋白排泄量间的关系 ,探讨其在高血压性肾损害发生发展中的作用及在早期诊断中的意义。方法 测定 5 7例常规检查尿蛋白阴性、肾功能正常的高血压患者高血压组血清和尿C Ⅳ、LN、C Ⅲ水平及晨尿白蛋白、β2 微球蛋白排泄量 ,并与 5 7名健康体检者(对照组 )比较 ,同时观察高血压组患者尿白蛋白、β2 微球蛋白与上述各指标间的相关关系。结果 高血压组患者血和尿C Ⅳ、LN及C Ⅲ水平均较对照组升高 ,除尿C Ⅳ外 ,均有显著性差异 (P <0 .0 5～ 0 .0 0 1) ;高血压组患者尿 β2 微球蛋白排泄量显著高于对照组 ,且与血、尿C Ⅲ水平呈显著正相关关系。结论 高血压患者在尚无肾脏损伤临床表现的早期 ,即可表现为血和尿C Ⅳ、LN及C Ⅲ水平的升高 ,尤其是血和尿C Ⅲ水平的升高 。

Objective To investigate the relationship between the variations of serum and urine type Ⅳ collagen(C-Ⅳ),laminin(LN)and type Ⅲ collagen(C-Ⅲ)and the degree of kidney lesion caused by hypertension.Methods Fifty-seven patients with essential hypertension without proteinuria and renal dysfunction and 57 controls were enrolled in this study.The concentrations of serum and urine C-Ⅳ,LN and C-Ⅲ as well as the urine albumin and β2-microglobin in both groups were detected and compared.In addition,the associations of urine albumin and β2-microglobin with serum and urine C-Ⅳ,LN and C-Ⅲ in the hypertension group were analyzed.Results In the hypertension group,serum C-Ⅳ,LN and C-Ⅲand urine LN and C-Ⅲ were significantly higher than those in the control group(P<0.05～0.001).The excretion of urine β2-microglobin in hypertension group also increased significantly and had a positive correlation respectively with the serum and urine C-Ⅲ.Conclusion There are increases of serum and urine C-Ⅳ,LN and C-Ⅲ in the early stage of hypertension without renal damage.The increased serum and urine C-Ⅲ may represent the existence of tubular and interstitial lesion.