不同病理类型肾病患者蛋白尿成分与肾脏病理的关系

目的 探讨不同病理类型原发性肾小球肾炎 (PGN) 患者的尿蛋白成分与肾脏病理的关系。 方法 对象为117例PGN患者。采用散射比浊法行尿蛋白成分分析。检测患者的Scr、24 h尿蛋白量。将上述指标与肾脏病理评分进行统计学分析。结果 轻微病变(MCD)患者尿白蛋白(Alb)浓度最高；尿β2微球蛋白(β2-MG)以硬化性肾小球肾炎(SGN)患者最高。在肾小管间质评分中，尿IgG/总蛋白(IgG/Tpro)、尿转铁蛋白(TRF)和β2-MG是主要的相关因子，而IgG/Tpro与肾小球硬化有相关性。尿TRF和β2-MG分别是IgA肾病(IgAN)和MCD患者肾小管间质损害评分的重要影响因子。尿TRF、IgG、λ轻链和β2-MG是影响膜性肾病(MN)肾小管间质损害评分的重要因素。结论 不同病理类型的PGN患者尿蛋白组成有差异，尿IgG、尿转铁蛋白及β2-MG浓度与肾小管间质损害的关系密切。

Correlation between urinary protein components and renal pathology in primary glomerulonephritis patients of different pathological types

Objective To investigate the correlation between urinary protein components and renal pathology in primary glomerulonephritis (PGN) patients of different pathological types. Methods One hundred and seventeen PGN patients without any special treatment were enrolled in this study. All these patients underwent renal biopsy. Scr and 24-hour urinary protein quantity were measured before the biopsy. Urinary samples were collected to analyze the protein components. Results The highest urinary concentrations of albumin (Alb) and β2-microglobumin (β2-MG) were found in patients with minimal change disease (MCD) and sclerosing glomerulonephritis (SGN)respectively. Urinary IgG/Tpro，transferrin (TRF) and β2-MG were significantly correlated with the renal tubulointerstitial scores (RTIS) and IgG/Tpro was also significantly correlated with the glomerular sclerosis. Urinary TRF and β2-MG were important influencing factors of RTIS in IgA nephropathy (IgAN) and MCD respectively， meanwhile， urinary TRF， IgG， λ light chain and β2-MG were important influencing factors of RTIS in membranous nephropathy (MN) as well. Conclusions There are differences of urinary components among PGN patients with different pathological types. Urinary IgG， TRF and β2-MG are significantly correlated with renal tubulointerstitial damage.