小儿肺炎β2-微球蛋白与肾功能损害关系探讨

目的 :观察小儿肺炎血、尿 β2 微球蛋白 (β2 MG)的含量变化 ,探讨 β2 MG与肾功能损害关系以及肾功能损害早期诊断的敏感指标。方法 :采用放射免疫分析法测定 14 5例儿童肺炎急性期和恢复期血、尿β2 MG含量 ,同时检测血清肌酐 (Cr)及尿素氮 (BU N) ;与 82例健康儿童对照组进行比较。结果 :肺炎急性期血、尿 β2 MG含量均显著高于对照组 (P均 <0 .0 1) ;恢复期与对照组比较无显著性差异 (P均 >0 .0 5 ) ;急性期与恢复期比较 ,二者有显著性差异 (P均 <0 .0 5 ) ;肺炎轻型与重型比较 ,有显著性差异 (P均 <0 .0 5 )。肺炎患儿血β2 MG与血清 Cr、BU N相互关系间呈正相关 (r BUN=0 .6 35 ,r Cr=0 .6 2 1;P均 <0 .0 5 )。急性期血β2 MG增高异常率 (81% )明显高于血 Cr(13% )及 BU N(19% )异常率。结论 :肾功能损害可能是小儿肺炎时伴随的较普遍现象 ,以重型肺炎更明显 ,肾功能损害是可逆性的 ;血、尿β2 MG是监测小儿肺炎早期肾功能损害较敏感的指标。

Relationship between the changes of β2-microglobulin in blood and urine and kidney involvements in children with pneumonia

OBJECTIVE: To investigate the relationship between the changes of serum and urine beta2-microglobulin (beta2-MG) in children with pneumonia and the renal impairment, and to explore the sensitive index for early diagnosis of renal injury. METHODS: The contents of serum and urine beta2-MG were determined with radio immunoassay in 145 cases with pneumonia at the stages of acute and convalescence and 82 healthy controls, serum creatinine (SCr) and blood urea nitrogen (BUN) were also determined at the same time. RESULTS: The contents of serum and urine beta2-MG in children with pneumonia at the stages of acute were significantly higher than those in controls (both P<0.01), and compared with convalescence, there was a significant difference (both P<0.05). There was no significant difference between the convalescence and healthy control groups. There were found to have a significant difference in these data between attack and interval stages, and mild and severe pneumonia in children (both P<0.05). At the same time, the study showed that there was significant positive correlation between serum beta2-MG and BUN or SCr in children with pneumonia (r(BUN)=0.635, r(Cr)=0.621; both P<0.05). The abnormal rate of serum beta2-MG at the acute stages was markedly higher than that of SCr and BUN. CONCLUSION: The major characteristics of children's pneumonia is a reversible renal injury, which is a widespread pneumonia to be following in children with pneumonia and it is more significant in severe pneumonia. Serum and urine beta2-MG can be a sensitive index of monitoring the kidney involvement at early stage of pneumonia in children.