急性白血病患者尿、唾液SIgA的变化

本文测定17例急性白血病发病期患者和18例缓解期患者的尿和唾液中SIgA含量,并与15例正常人作对照。发现尿中SIgA在三组中无显著性差异。唾液中SIgA在发病组明显低于正常人组(P<0.05)。而缓解组则接近正常人组,(P>0.05)。同时测定化疗前后及感染时尿、唾液中的SIgA变化。结果显示化疗对SIgA无显著性影响。而合并感染时尿、唾液中SIgA均有显著增高。     

糖尿病患者尿SIgA测定的临床意义

本文用放射免疫分析法测定了65例糖尿病患者24小时尿分泌型IgA(SIgA)的排泄量,并与20例正常人对照,以探讨尿SIgA测定在糖尿病肾病中的意义,现报告如下。对象和方法按WHO标准诊断糖尿病患者65例(男43例,女22例),年龄21～72岁,其中IDDM 16例,NIDDM 49例。根据尿白蛋白的排泄率(AER)将病人分为三组:①正常蛋白尿组,32例,AER<15μg/分;②微量蛋白尿组,23例,AER 15～200μg/分;③临床蛋白尿组,10例,AER>200μg/分。正常对照组20例(男女各半),年龄25～68岁,AER<15μg/分。受检对象准确留取24小时尿,并记录尿量。     

DM2及合并肾病患者血浆Hcy及尿Alb水平的变化

目的：探讨2型糖尿病（DM2）及合并肾病患者同型半胱氨酸（Hcy）的变化情况。方法：设正常对照组、无并发症糖尿病组、合并肾病组三组,比较三组间血清Hcy的水平。结果：两组糖尿病患者间空腹血糖水平无显著差异;BUN和Cr在三组间无差异,但糖尿病合并肾病患者尿Alb较无并发症组明显升高（P〈0.01）;糖尿病各组血清总Hcy浓度均明显高于正常对照组（P均〈0.01）,其中合并肾病患者增高更为明显,与无并发症组亦有明显差异（P〈0.01）。结论：在两组糖尿病患者中Hcy均有明显增高,且在有肾病合并症的患者中不仅尿Alb比无合并症患者明显增高,Hcy也明显增高,但肾功能损伤并未进入失代偿期,在临床上有必要对糖尿病患者检测血浆总Hcy水平,及时进行干预治疗,从而预防或缓解糖尿病的进一步发展。     

高血压肾病早期血尿NGAL水平的变化及临床意义

目的:研究高血压肾病早期血尿NGAL(中性粒细胞明胶酶相关脂质运载蛋白)水平的变化及其临床意义。方法:选取90例原发性高血压患者按24 h尿微量白蛋白排泄率(Urinary microalbumin excreting rate,UAER)分为正常蛋白尿组(A组,30例,UAER<30 mg/24 h),微量蛋白尿组(B组,30例,UAER介于30~300 mg/24 h)及大量蛋白尿组(C组,30例,UAER>300 mg/24 h);30例健康体检人员(D组)。检测各组患者血、尿NGAL含量,血肌酐(Serum creatinine,Scr)、尿素氮(Blood urea nitrogen,BUN)、半胱氨酸蛋白酶抑制剂C(Cystatin C,Cys C)、超敏C反应蛋白(High sensitive C reactive protein,hs CRP)、尿转铁蛋白(Transferrin,TF)含量及清晨基础血压(Blood pressure,BP)。1年后随访同一批患者,再次检测上述各指标,比较随访前后各指标的改变,分析血、尿NGAL的相互关系,同时分析二者与其他各指标的相互关系。结果:90例原发性高血压肾病患者中微量蛋白尿组与大量蛋白尿组血清NGAL与GFR水平较正常对照组明显下降,尿NGAL较正常对照组明显升高,差异有统计学意义(P<0.05)。30例正常蛋白尿组与正常对照组比较未见明显异常。结论:血尿NGAL水平在高血压肾病早期较正常对照组已有明显趋势性变化,可作为其早期肾脏并发症的可靠指标。     

慢性肾脏疾病患者尿SOD排泄变化

为了探索肾脏超氧化物歧化酶（ＳＯＤ）在慢性肾脏疾病发生,发展中的作用,采用放免方法测定了６０例慢性肾小球疾病患者尿ＳＯＤ的排泄变化,其中慢性肾炎１２例,肾病综合征２６例、轻中度慢性肾衰１０例,重度慢性肾衰１２例。结果发现,四组患者尿ＳＯＤ排泄均高于正常对照组,而肾病综合征组明显高于其它三组;慢性肾炎组明显高于轻、中度和重度慢性肾衰组,而轻、中度慢性肾衰组与重度组无显著差异。血ＳＯＤ除肾病综合征且高     

2型糖尿病患者尿白蛋白排泄率与骨密度的研究

目的探讨糖尿病患者尿白蛋白排泄率(AER)与骨密度(BMD)的关系.方法测定了63例2型糖尿病患者24h AER,根据AER分为A组即正常白蛋白尿组(AER<20μg/min)、B组即微量白蛋白尿组(20μg/min≤AER≤200μg/min)、C组即大量白蛋白尿组(AER≥200μg/min),并分别测定其L2~4椎体、双侧股骨Ward区BMD.结果除A组患者BMD与对照组无明显差异(p>0.05);B、C组患者BMD与对照组差异明显(p<0.01);糖尿病患者中,C组BMD明显低于A组(p<0.01).结论糖尿病肾病患者BMD比正常人低,大量蛋白尿组BMD较其它组显著下降.     

2型糖尿病患者尿白蛋白排泄率与骨密度的研究

目的探讨糖尿病患者尿白蛋白排泄率(AER)与骨密度(BMD)的关系.方法测定了63例2型糖尿病患者24h AER,根据AER分为A组即正常白蛋白尿组(AER<20μg/min)、B 组即微量白蛋白尿组(20μg/min≤AER≤200μg/min)、C组即大量白蛋白尿组(AER≥200μg/min),并分别测定其L2～4椎体、双侧股骨Ward区BMD.结果除A组患者BMD与对照组无明显差异(p>0.05);B、C组患者BMD与对照组差异明显(p<0.01);糖尿病患者中, C组BMD明显低于A组(p<0.01).结论糖尿病肾病患者BMD比正常人低, 大量蛋白尿组BMD较其它组显著下降.     

同位素肾图对诊断糖尿病肾病的临床价值探讨

目的探讨同位素肾图诊断糖尿病肾病的临床价值。方法 2008年至2011年34例2型糖尿病患者根据尿蛋白排泄率分为无蛋白尿、微量蛋白尿、临床蛋白尿三组进行了同位素肾图检查,与15例查体人员（正常对照组）同位素肾图比较,比较有效肾血浆流量,肾功能曲线峰时15 min残留率。结果 2型糖尿病无蛋白尿组、微量蛋白尿组、临床蛋白尿组分别与正常对照组比较,15 min残留率均升高;2型糖尿病并临床蛋白尿时,肾脏指数明显降低,有效肾血浆流量明显下降。结论同位素肾图能反映2型糖尿病早期肾病的肾脏血流动力学改变,可早期了解糖尿病患者肾脏受损程度,为临床治疗和随访提供依据。     

2型糖尿病患者晨尿Alb/α1-mG比值的临床分析

目的探讨2型糖尿病早期肾损害的部位。方法同期检测33例2型糖尿病患者和20例正常人晨尿A lb/Cr比值、A lb和α1-mG浓度,并计算A lb/α1-mG比值。结果(1)2型糖尿病正常白蛋白尿组晨尿α1-mG浓度比对照组显著增高;晨尿A lb/α1-mG比值有所下降,但无统计学意义。(2)2型糖尿病微量白蛋白尿组晨尿A lb和α1-mG浓度比对照组显著增高;晨尿A lb/α1-mG比值有所上升,但无统计学意义。(3)2型糖尿病微量白蛋白尿组与2型糖尿病正常白蛋白尿组相比晨尿A lb和α1-mG浓度及A lb/α1-mG比值均有显著升高。结论2型糖尿病在尿白蛋白尚在正常范围时已有近端肾小管受损,在微量白蛋白尿时肾损害以肾小球受损为主。     

血清C-反应蛋白、TNF-α、IL-6与2型糖尿病肾病的关系

目的探讨血清C-反应蛋白（CRP）、TNF-α及IL-6与2型糖尿病肾病的关系。方法根据尿白蛋白排泄率（UAER）选取64例2型糖尿病患者,其中糖尿病肾病40例,分别为蛋白尿组1（DN1）18例和临床蛋白尿组2（DN2）22例,其余为正常蛋白尿组（DM）24例。另选40例作为正常对照组。观察各组血清CRP、TNF-α及IL-6水平。血清CRP水平采用ELASA法测定,TNF-α及IL-6水平采用电化学发光法测定。结果DN1组及DN2组血清CRP、TNF-α及IL-6水平较正常对照组升高,与DM组比较也升高,而DN2组升高的更明显。DN1组及DN2组血清CRP与TNF．仅及IL-6呈正相关。结论血清CRP、TNF-α及IL-6水平与糖尿病肾病的程度呈一致性。     

Urinary mannose-binding lectin is a biomarker for predicting the progression of immunoglobulin (Ig)A nephropathy

Complement system activation is associated with immunoglobulin A nephropathy (IgAN) activity and progression. The aim of the present study was to investigate the importance of urinary mannose-binding lectin (MBL), at the time of renal biopsy, for evaluating disease severity and predicting the progression of IgAN. A total of 162 patients with biopsy-proven IgAN were enrolled and 50 healthy individuals were selected as normal controls. Urinary MBL was measured by sandwich enzyme-linked immunosorbent assay (ELISA) and normalized for urinary creatinine concentration. Urinary MBL was significantly higher in IgAN patients than that in normal controls, and elevated as histopathological phenotypes upgraded. Urinary MBL was correlated significantly with the well-known clinical predictors for the prognosis of IgAN; that is, renal function (represented by serum creatinine and estimated glomerular filtration rate), proteinuria and arterial hypertension. Urinary MBL was demonstrated to be correlated with the histopathological parameters which have independent value in predicting renal outcome of IgAN according to the Oxford classification; that is, mesangial hypercellularity, segmental glomerulosclerosis, endocapillary hypercellularity and tubular atrophy/interstitial fibrosis. More importantly, non-remission patients at the end of follow-up had significantly higher levels of urinary MBL compared with patients in remission. In conclusion, urinary MBL can be a reliable non-invasive biomarker for evaluating disease severity and predicting the prognosis of IgAN. This is the first report on this issue. However, our conclusions should be verified further in large-scale studies with long-term follow-up.     

肾活检组织中NEP的表达及其与尿NEP含量之间的相关性研究

目的 观察肾活检组织中NEP的表达,研究它与尿NEP含量之间的关系,以期探讨检测尿NEP的临床意义。方法 将研究组分为对照组(n=100),肾小球疾病组(n=31)、急性肾小管损伤组(n=44)、慢性肾小管损伤组(n=61)、慢性肾功能衰竭组(n=13)。收集各组病人晨尿,然后通过荧光光谱分析,得到尿中NEP的量,并用相应尿肌酐值予以标化。同时对病人组中的68例患者的肾组织切片用免疫组化的方法进行染色,直接观察NEP的在肾组织中的表达情况,且进行其表达量与尿NEP的相关性研究。结果 正常对照组尿NEP为68.41ug/mmol Cr,急性肾小管损伤组尿NEP196.36ug/mmol Cr,明显高于正常对照组(P=0.0001),慢性肾小管损伤组、肾小球疾病所致的CRF组尿NEP分别为31.98、19.40ug/mmol Cr,均明显低于正常对照组(P均<0.01),而单纯肾小球疾病组尿NEP为75.49ug/mmol Cr,与正常对照组无差异(P=0.1425)。在急性肾小管损伤组和慢性肾小管损伤组,尿NEP与肾组织中NEP的表达均呈正相关,而肾小球疾病组内尿NEP与肾组织中NEP的表达无明显相关性。结论 肾小管刷状缘上NEP的表达量与近端小管损伤有良好相关性,尿NEP量实际反映近端小管刷状缘损伤情况。本研究在国内率先建立了尿NEP的检测方法,并用于临床研究。对尿中NEP的检测,提供了一种快速、非损伤性测量手     

Developmental profiles of urinary SIgA in newborns and the effect of blood transfusion.

Urinary levels of secretory immunoglobulin A (SIgA) and serum levels of IgA were determined in mature and premature newborns with sensitive enzyme immunoassay methods. On the first or second day following birth, SIgA (3-7 ng/ml) was detected in the urine of both mature and premature babies and the levels tended to decrease for a few days. Beginning with the seventh day after birth, a sharp increase in the urinary levels of SIgA was found in both groups of babies, and at 2 weeks their urine contained about 100 ng/ml of SIgA. A similar developmental profile was seen in serum IgA levels. Upon blood transfusion urinary SIgA levels increased within a day but then gradually fell to normal. A similar change in serum IgA levels was seen in the same patient. A patient who received a massive blood transfusion showed markedly high levels of urinary SIgA.     

尿白介素—8检测在狼疮性肾炎病情判断中的价值

目的探讨尿白介素 - 8(IL- 8)检测在狼疮性肾炎 (L N)病情判断中的价值。方法应用 EL ISA双抗体夹心法检测 38例 L N患者尿 IL - 8水平。结果 1L N患者肾功正常组和肾功不全代偿期组尿 IL - 8水平显著高于健康人 (P<0 .0 0 1) ,且肾功不全代偿期组尿 IL- 8水平显著高于肾功能正常组 (P<0 .0 1) ,高尿 IL- 8水平患者伴较高的血沉值和较低的补体 C3值。2出现白细胞尿的 L N患者尿 IL- 8水平显著高于其它患者 (P<0 .0 5 )。3环磷酰胺静脉冲击加强的松治疗 4周后 ,L N患者尿 IL- 8水平显著降低 (P<0 .0 1)。结论尿 IL - 8水平的变化可能有助于判断狼疮活动和肾损害程度。L N患者非感染性白细胞尿的出现可能与尿 IL- 8水平增高有关。环磷酰胺和强的松可能通过抑制免疫细胞和肾固有细胞产生 IL- 8而取得疗效     

Urinary C-X-C Motif Chemokines 13:a Noninvasive Biomarker of Antibody-Mediated Renal Allograft Rejection

Objective: Since acute rejection remains one of the major complications which necessitate periodic surveillance, noninvasive diagnostic/prognostic methods are preferred by renal transplant recipients. Here, we explored whether urinary C-X-C motif chemokines 13(CXCL13) could be a potential candidate to reflect ongoing immune processes within the renal graft. Methods: We investigated urinary CXCL13 levels by a cross-sectional analysis of 146 renal allograft recipients and 40 healthy controls. Besides, a subset of patients(n=57) were followed-up for kinetic monitoring of immune status.Results: Urinary CXCL13/Cr was lower in normal transplants compared to those with acute tubular necrosis(ATN, P=0.001), chronic allograft nephropathy(CAN, P=0.01) and acute rejection(AR, P0.0001), which yielded a good diagnosis performance of urinary CXCL13 for AR(AUC=0.818, P0.0001). Interestingly, urinary CXCL13 further distinguished acute antibody mediated rejection(ABMR) from acute cellular rejection,with an AUC of 0.856. Besides, patients with steroid-resistant acute rejection had distinctly greater urinary CXCL13/Cr levels than patients with reversible acute rejection,P=0.001. Follow-up data revealed that urinary CXCL13/Cr varied in line with the occurrence of ABMR. Furthermore, elevated levels of urinary CXCL13/Cr within the first month was predictive of graft function at 3, 6 months, P=0.044 and 0.4. Conclusion: This study demonstrates that monitoring of urinary CXCL13/Cr might be a valuable noninvasive approach for the detection of AR, especially ABMR. Additionally, high urinary CXCL13/Cr levels related to the poor response to steroid treatment and predicted a compromised graft function after AR.     

Diabetic nephropathy and plasminogen activator inhibitor 1 in urine samples

Plasminogen activator inhibitor-1 (PAI-1) may contribute to renal fibrosis because of its involvement in matrix (ECM) accumulation through inhibition of plasmin-dependent ECM degradation. The aim of this study is to determine urinary PAI-1 concentrations and its intrarenal localization in patients with various renal diseases and to identify inducers for PAI-1 expression in human cultured proximal renal tubular cells (HRCs). Urinary PAI-1 concentrations were significantly higher in patients with overt diabetic nephropathy (DN, n=36) than in proliferative glomerulonephritis (PGN, n=8), nephrotic syndrome (NS, n=10) and healthy controls (n=12). Urinary PAI-1 concentrations (ng/gCr) were directly correlated with urinary N-acetyl glucosaminidase (NAG) levels (r=0.58, p<0.05). As for intrarenal localization of PAI-1 antigen, strong stainings for PAI-1 were observed in proximal tubular cells of renal biopsy samples from patients with DN, while no stainings for PAI-1 were found in renal tissues of PGN or NS. Immunoblot analysis revealed the presence of PAI-1 protein in whole cell lyzates from HRCs grown to semiconfluency. Exposure of growth-arrested HRCs with hypoxia (1% O2) or TNF-alpha (10 ng/ml) for 24 hours increased the secretion rate of PAI-1 protein by about 2.0-fold, while 24-hour treatment with high glucose (450 mg/dl) did not increase PAI-1 secretion at all, compared with that of the control cells under normal glucose (100 mg/dl) and normoxia (18% O2). These findings suggest that PAI-1 expression is upregulated especially in the proximal renal tubular cells of DN, which may be explained partially by hypoxia and inflammatory cytokines but not high glucose.     

唾液SIgA、溶菌酶含量与慢性支气管炎关系的探讨

目的：探讨了慢性支气管炎患者唾液SIgA和溶菌酶含量的变化及临床意义。方法：应用放射免疫分析检测38例慢性支气管炎患者唾液SIgA含量,免疫扩散法测定溶菌酶含量,并与35名正常人作比较。结果：慢性支气管炎患者唾液SIgA和溶菌酶含量非常显著地高于正常人组（P〈0．01）,经2周治疗后仍有显著性差异（P〈0．05）。结论：检测慢性支气管炎患者唾液SIgA和溶菌酶含量的变化对临床观察预后有重要的临床价值。     

The clinical significance of serum and urinary neopterin levels in several renal diseases

Neopterin is a pyrazino-pyrimidine compound, and is known to be a marker associated with cell-mediated immunity in various diseases. We hypothesized that the levels of serum and urine neopterin would be elevated in renal disease, and would correlate with certain clinical parameters. We evaluated serum and urinary neopterin levels in patients with several renal diseases, including nephrotic syndrome (NS, n=19), chronic renal failure (CRF, n=8), end stage renal disease (ESRD, n=64) and controls (n=22). Serum neopterin was elevated in patients with CRF and ESRD, as compared to controls. Urinary neopterin levels were also found to be elevated in patients with CRF and ESRD, as compared to controls. Serum neopterin levels showed significant positive correlation with age, serum BUN and creatinine levels, and inverse correlation with WBC, hemoglobin, hematocrit, serum albumin and total iron binding capacity. Urine neopterin levels exhibited positive correlation with age and serum creatinine levels, and inverse correlation with WBC, hemoglobin, hematocrit, BUN and serum albumin. In conclusion, increased serum and urinary neopterin levels were found in some patients with renal disease and were correlated with certain clinical parameters.     

唾液SIgA、溶菌酶含量与牙周病关系的探讨

目的：探讨了牙周病患者唾液SIgA和溶菌酶含量的变化及临床意义。方法：应用放射免疫分析检测32例牙周病患者唾液SIgA含量、免疫扩散法检测溶菌酶含量,并与35名正常健康人作比较。结果：牙周病患者唾液SIgA和溶菌酶含量均非常显著地高于正常人组（P〈0.01）,经治疗1个月后与正常人组比较仍有显著性差异（P〈0.05）。结论：检测牙周病患者唾液SIgA和溶菌酶含量的变化对临床观察预后有重要的临床价值。