尿RBP NAG检测在早期诊断过敏性紫癜肾小管损伤的临床意义

目的　观察过敏性紫癜、紫癜性肾炎患儿尿视黄醇结合蛋白 (RBP)、尿-N -乙酰-β-D -氨基 -葡萄糖苷酶 (NAG)与肾小管受损之间的关系。方法　采用ELISA法测定 2 3例过敏性紫癜 (第 1组 ) ,31例紫癜性肾炎 (第 2组 )和 38例正常对照组儿童的尿RBP和尿NAG的含量。结果　第 1组尿RBP排量 (2 0 .9± 17.2 ) μg/mmolCr,第 2组尿RBP排量 (2 5 .7± 2 2 .8) μg/mmolCr,与对照组 (10 .4± 4.8) μg/mmolCr比较 ,差异有显著性意义 ,P <0 .0 5 ,P <0 .0 1。第 1组与第 2组之间比较差异无显著意义 ,P >0 .0 5。第 2组尿NAG排量 (3.6± 4.4)U/mmolCr ,明显高于第 1组 (1.5± 0 .8)U/mmolCr和对照组 (1.5± 0 .9)U/mmol,差异有显著性意义 (P <0 .0 5 ,P <0 .0 1)。结论　过敏性紫癜患儿尽管尿检正常 ,其近端肾小管已有不同程度损害 ,而紫癜性肾小管损害更明显。

Department of Nephrology, Shanghai Children's Hospital, Shanghai 200040,China

Objective To explore the relationship between urine retinol-binding protein (RBP), N-acety 1-B-D-amino-clucosidic enzyme (NAG) and renal tubular injuries in children with anaphylacoid purpura (AP) and purpura nephritis (PN). Methods Using ELISA, the concentration of urine RBP and NAG were determined. Ninty-two cases were divided into three groups: Group 1 (23 cases of AP), Group 2 (31 cases of PN) and Group 3 (38 normal children). Results There was a significant difference in urine RBP concentration between Group 1 ( 20.9 ± 17.12 μg/mmol Cr) and Group 3 ( 10.3 ± 4.8 μg/mmol Cr), ( P < 0.05 ), and Group 2 ( 25.7 ± 22.8 μg/mmol Cr) and Group 3 ( P < 0.01 ). No difference was noted between the first and second groups ( P > 0.05 ). As to the urine NAG capacity, there was no difference between the first group ( 1.5 ± 0.8 U/mmol Cr) and the control group ( 1.5 ± 0.9 U/mmol Cr), ( P > 0.05 ), a prominent difference was noted between the second group ( 3.6 ± 4.4 U/mmol Cr) and the control group, ( P < 0.01 ), and there was a difference between the first group and the second group as well, ( P < 0.05 ). Conclusions Despite normal urinary findings in AP patients there exist varing degree of proximal renal tubule damage, more so in the PN, in different levels if the urine routine has changed, and so would be the distal renal tubule.