瘦素在儿童肾小球疾病中的变化

目的:探讨儿童肾小球疾病(肾病综合征、急性肾小球肾炎、紫癜性肾炎)血清瘦素(leptin)的变化。方法:对93例肾小球疾病患儿(排除肥胖患儿)清晨空腹测血清leptin,其中肾病综合征33例、急性肾小球肾炎31例、紫癜性肾炎29例;并测24小时尿蛋白定量、血胆固醇、血尿素氮及肌酐、尿N-乙酰-β-氨基葡萄糖苷酶(NAG)。设正常对照组26例均为健康体检儿童,清晨空腹测血清leptin。分别比较3组疾病与正常对照组之间的血leptin差异,3组疾病之间血清leptin的差异;分析血清leptin与尿蛋白定量、血胆固醇、血尿素氮及肌酐、尿NAG酶之间的关系。结果:3种疾病患儿的血清leptin都较正常对照组明显升高,有统计学意义(P<0.05),且以肾病综合征和急性肾小球肾炎组升高最明显(P<0.01);血清leptin与尿蛋白定量、血胆固醇呈正相关(P<0.05),与血尿素氮及肌酐、尿NAG酶无相关性(P>0.05)。结论:儿童肾病综合征、急性肾小球肾炎、紫癜性肾炎的血清leptin均有不同程度的升高,说明血清leptin水平可作为临床判断肾脏滤过吸收功能状态的一个间接指标,对临床治疗具有一定指导价值。

The changes of the serum Leptin in the children with Renal glomerular diseases

Objective:To investigate the changes of the serum LEP caused by children renal glomerular diseases (including nephritis syndrome, acute glomerulonephritis and purpuric nephritis). Methods: The serum LEP of 93 children (obese children elimi- nated) with renal glomerular disease was tested in the early morning on empty stomachs. These children were divided into three groups. 33 of them suffered from nephritis syndrome and are under either initial treatment or retreatment. 31 of them suffered from acute glomerulonephritis and the rest 29, from purpuric nephritis. Meanwhile, another 26 children, who had been tested by our hospital to be healthy, were set as a contral group. The differences in the serum LEP between the children with renal glomerular diseases in the three groups and the healthy children in the extra group and also the differences in the serum LEP among the children with renal glomerular diseases in the three groups were compared. Result:The serum LEP of the children in the three groups with Renal glomerular diseases are patently higher than that of the healthy children in the contral group, showing statistic significance (P<0.05). Meanwhile, the chil- dren with nephritis syndrome and the ones with acute glomerulonephritis has a more patent rise. The serum LEP has a direct correlation with Urine protein quantitation and cholesterin(P<0.05) but has no correlation with blood urea nitrogen, creatinine and the ur-NAG bio- catalyst (P>0.05).Conclusion: The serum LEP of the children with nephritis syndrome, acute glomerulonephritis and purpuric nephritis all experience various degrees of rise. It can be concluded that the serum LEP can be used as an indirect index to test the condition of filtration the absorptive function in clinical judgment as well as used to guide clinical therapeutics.