肾小管功能检测在IgA肾病中的临床意义

Clinical Significance in Detecting Renal Tubule Function on IgA Nephropathy

目的 探讨肾小管功能检测在IgA肾病 (IgAN)中的临床意义。方法 分析 32例IgAN患者的临床与病理资料 ,探讨肾小球及间质病理损害程度与肾小管功能 (尿NAG酶、尿LYS及渗透压 )的关系。结果 肾小管间质损害情况 :肾小管间质损害轻度者占 4 3 75 % (14 /32 ) ,中重度者占 34 37% (11/32 ) ,无肾小管间质损害者 2 1 87% (7/32 )。肾小管间质损害与肾小管功能的关系 :肾小管间质损害中、重度者尿NAG酶(4 2 75± 2 4 10 0 )U/mmol cr,尿渗透压 (4 99 6 15± 2 2 4 6 75 9)mOsm/kg ;小管间质损害轻度者尿NAG酶 (1 75 1± 1 5 498)U/mmol cr,尿渗透压 (6 5 3 92 3± 2 5 8 86 18)mOsm/kg ;无肾小管间质损害者尿NAG酶 (1 5 31±1 4 378)U/mmol cr,尿渗透压 (783 35 3± 16 3 4 35 1)mOsm/kg。小管间质中重度损害者同其他 2组比较 ,其尿NAG酶及尿渗透压有显著性差异 ,P <0 0 5 ;尿LYS在各组之间无显著性差异 ,P >0 0 5。结论 IgA肾病常合并小管间质损害 ,肾小管功能中尿NAG酶及尿渗透压改变与肾脏小管间质损害程度成对应关系。

Objective To discuss the clinical significance in detecting renal tubule function in IgA nephropathy. Methods The clinical and pathological data of 32 cases and their relation between degree of pathological lesion of glomerulus, renal interstitial and tubule function (including the levels of NAG enzyme, LYS and osmotic pressure in urine) were analyzed. Results The conditions of renal interstitial lesion: the mild was 14/32, the middle and severe were 11/32 and no lesion was 14/32. The relation between degree of pathological lesion of renal interstitial and renal tubule function was that the levels of NAG enzyme in urine in patients with middle and severe lesion was (4.275±2.4100)U/mmol.cr , osmotic pressure of urine was (499.615±224.6759)mOsm/kg.H 2O. The level of NAG enzyme in urine in patient with mild lesion was (1.751±1.5498)Ummol.crosmotic pressure of urine was (653.923±258.8618)mOsm/kg.H 2O. The level of NAG enzyme and osmotic pressure in patient with middle and severe lesion had significant difference compared with other groups (P<0.05). The levels of LYS in urine among all group had no significant difference. Conclusion IgA nephropathy usually complicated with renal tubule interstitial lesion. Alteration of levels of NAG enzyme in urine when detecting this function could be correlated to the lesion.