摘要
目的 观察儿童肾小球疾病时尿蛋白和尿转铁蛋白(TRF)与肾小管-间质病变的关系及其临床意义。方法 对22例肾小球肾炎患儿(单纯性血尿9例,单纯性肾病5 例,血尿伴蛋白尿8 例)进行肾组织活检,并对肾小球、肾间质病变程度进行评分,同时测定尿TRF。结果 ①儿童肾小球肾炎单纯性血尿、单纯性肾病者的肾小管间质病变较轻,预后较好;血尿伴蛋白尿者肾小管间质病变明显,与单纯性血尿和单纯性肾病患儿的差异有显著性(P<0.05),易发生慢性肾功能不全。②3组间肾小球损害的差异无显著性(P>0.05),22 例患儿的肾小球病变与肾小管间质病变不相关(P=0.234)。③单纯性肾病、血尿伴蛋白尿患儿的尿TRF明显增高,与单纯性血尿患儿的差异均有显著性(P<0.05)。④血尿伴蛋白尿患儿肾小管间质病变与尿TRF增高呈正相关性(r=0.615,P=0.025)。⑤单纯性肾病患儿尿TRF亦明显增高,其肾小管间质病变较轻,可能与治疗效果较好、尿蛋白和尿TRF持续时间较短有关。结论 儿童肾小球疾病的发展和预后不仅与肾小球本身的病变有关,更与肾小管间质病变的严重程度密切相关,尿蛋白和尿铁离子可导致肾小管间质损害。
Objective To study the correlations between proteinuria, urinary transferrin (TRF) and tubulointerstitial lesions in children with primary glomerulonephritis. Methods Renal biopsy was performed in 22 pediatric glomerulonephritis patients, including 9 cases of simple hematuria, 5 simple nephrotic syndrome, and 8 hematuria accompanied by proteinuria, of which the glomerulopathy and tubulointerstitial lesions were scored, and urinary TRF measured. Results ①The tubulointerstitial lesion was more severe in patients with hematuria accompanied by proteinuria than in those with simple hematuria or simple nephrotic syndrome. The statistical differences (P=0.002, 0.004) were very significant. The simple hematuria and simple neprotic syndrome patients had better prognosis, and the patients with hematuria accompanied by proteinuria tended to progress towards chronical renal insufficiency; ②There was no significant statistical difference (P>0.05) in glomerulopathy of all patients; ③The urinary TRF level in patients with simple nephrotic syndrome and hematuria accompanied by proteinuria was significantly increased in comparing with that in simple hematuria (P=0.023, 0.001); ④It was found that significant correlation existed between tubulointerstitial lesion and TRF (r=0.615, P=0.025) in patients with hematuria accompanied by proteinuria; ⑤No relationship was found between glomerulopathy and tubulointerstitial lesion (P=0.234). Conclusions The progression and prognosis of glomerulonephritis in children are not only associated with glomerular lesion but are also closely related to the severity of tubulointerstitial lesion. Proteinuria and urinary TRF can lead to tubulointerstitial damage.
出处
《上海医学》
CAS
CSCD
北大核心
2005年第3期214-216,共3页
Shanghai Medical Journal
