慢性原发性肾小球疾病中医本虚证候蛋白尿患儿的尿蛋白水平及组分比较

目的:观察慢性原发性肾小球疾病蛋白尿患儿中4种中医本虚证型的分布,探讨其与尿蛋白水平及组分的相关性。方法:收集临床慢性原发性肾小球疾病符合脾气亏虚型、气阴两虚型、肝肾阴虚型及脾肾阳虚型4种本虚中医证型的56例蛋白尿患儿,观察各型在蛋白尿患儿中的比例,比较各型患儿的24h尿蛋白定量、尿微量白蛋白(mAlb)、免疫球蛋白G(IgG)、β2-微球蛋白(β2-MG)、α1-微球蛋白(α1-MG)和转铁蛋白(TRF)的水平。结果:4种本虚型蛋白尿患儿中,脾肾阳虚型最为少见,以气阴两虚型最多,肝肾阴虚型次之。气阴两虚型尿IgG、mAlb含量分别为(257.6±357.8)mg/L、(4 479.7±3 817.3)mg/L,较肝肾阴虚型(61.9±88.4)mg/L、(2 226.1±3 135.3)mg/L显著升高(P<0.05),而β2-MG、α1-MG及TRF均无显著差别。气阴两虚型24h尿蛋白定量较脾气亏虚及肝肾阴虚型均有较明显升高趋势,肝肾阴虚型β2-MG较其他两型有较明显升高趋势。结论:慢性原发性肾小球疾病蛋白尿患儿中不同中医本虚证候与尿蛋白组分之间存在着一定的相关性。

Comparison of urinary protein level and composition in deficiency types children with proteinuria

Objective:To observe the distribution of four deficiency types of TCM syndrome in Children with proteinuria and investigate the relativity between it and urinary protein amount and Composition.Methods:56 proteinuria Children with Pi qi-deficiency type,qi-yin deficiency type,Gan-Shen yin-deficiency type and Pi-Shen yang-deficiency type respectively were collected and compared the proportion and the levels of 24hys proteinuria,mALB,IgG,β2-MG,α1-MG and TRF in each type.Results:In the four types,Pi-Shen yang-deficiency type is seldom and the most is qi-yin deficiency type.Compared with Gan-Shen yin-deficiency type(61.9±88.4)mg/L and(2 226.1±3 135.3)mg/L respectively],the levels of IgG and mAlb in qi-yin deficiency type(257.6±357.8) mg/L and(4 479.7±3 817.3)mg/L respectively] were significantly higher(P<0.05),but no difference in β2-MG,α1-MG and TRF.There were no obviously difference between Gan-Shen yin-deficiency type and Pi qi-deficiency type.There was a increasing tendency the the 24hrs proteinuria value of qi-yin deficiency type higher than those of qi-deficiency type and Gan-Shen yin-deficiency type.The value of β2-MG in Gan-Shen yin-deficiency type had similar tendency than other two types.Conclusion:There is certain relativity between deficiency types of TCM syndrome and urinary protein composition in children with proteinuria.