SDS-AGE尿蛋白电泳与原发性IgA肾病病理的相关分析

Sodium Dodecyl Sulfate-agarose Gel Electrop horesis of Urinary Proteins and Pathologic Characters of Primary IgA Nephropathy

目的:探讨十二烷基硫酸钠鄄琼脂糖凝胶电泳(SDS鄄AGE)法尿蛋白电泳检测在原发性IgA肾病(IgAN)的预后和随访中的应用价值。方法:对经肾病理确诊为原发性IgAN患者125例行SDS鄄AGE尿蛋白电泳,结合临床实验室检查及肾病理分型观察分析。结果:IgAN肾病理Hass分型示Ⅰ型15例,Ⅱ型28例,Ⅲ型52例,Ⅳ型20例,Ⅴ型10例。血清IgA水平各组间差异无显著性,除HassⅣ型24h尿蛋白高于各组外,余组无差异。血清肌酐(SCr)Ⅰ～Ⅴ型呈逐渐升高。尿蛋白电泳检测2例阴性,余均伴不同程度中、高分子性蛋白尿。混合性蛋白尿检出率在HassⅡ～Ⅴ型中呈升高趋势。中、高分子量蛋白条带和低分子量蛋白条带光密度值(D)分别在Ⅱ～Ⅴ型和Ⅲ～Ⅴ型中上升。讨论:IgAN中混合性蛋白尿检出率随病理肾损伤加重而增加,与SCr变化规律相似。中高分子蛋白排泄和低分子蛋白排泄也随之而逐渐增多,提示尿蛋白电泳可用于原发性IgAN的长期、动态随访,并有助于评估肾病预后。

Objective:To ev aluate the role of urine protein analysis by sodium dodecyl sulfate-agarose gel electrophoresis of urinary proteins(SDS-AGE)technique in follow-up and progno sis of primary IgA nephropath,and to analyse the correlation between urine prote in electrophoresis and pathologic patterns of IgA nephropath.Methods:A total of1 25patients with primary IgA nephropath(48men,77women;mean age34±10years,range13-76years)were studied.Urine protein was analyzed in all patients by SDS-AGE an d data were processed with laboratory tests and pathologic patterns.Results:Glom erular histology of Hass's classification:15of subclassⅠ,28of subclassⅡ,52of subclassⅢ,20of subclassⅣ,10subclassⅤ.Level of serum IgA and urine protein exc retion of24h(U 24hpro )had no statistic difference among all the groups of classificate,execpt tha t the U 24hpro in group of subclassⅣwas higher than the those of the others.From subclass ⅡtoⅤ,serum creatinine(SCr)increase was accompanied with the same manifestation of positive ratio of mixed urine protein,and the optical density(D)value of low and high molecular weight urine protein band rose in subclassⅡ-ⅤandⅢ-Ⅴres pectively.Conclusion:Mixture proteinuria was increased with the degree of renal lesion and the changes of SCr level and excretion of low molecular weight of uri ne protein may be used as an dynamic indicator of follow-up and a marker of pro gnosis.