尿核心蛋白聚糖检测在小儿肾脏病中的临床意义  

Clinical Significance of Testing Urine Decorin in Children with Kidney Disease

作　　者：陈颖[1] 鲍华英[1] 施圣云[1] 张维真[1] 吴红梅[1] 

机构地区：[1]南京医科大学附属南京儿童医院肾脏内科,南京210008

出　　处：《实用儿科临床杂志》2009年第17期1339-1340,共2页Journal of Applied Clinical Pediatrics

基　　金：南京市科技局人才培养项目资助(200306062)

摘　　要：目的探讨肾脏病患儿尿核心蛋白聚糖(decorin)水平与肾脏病理损伤程度的关系。方法选择2006年9月-2007年12月行肾活检的肾脏病患儿49例。收集患儿的临床指标及24 h尿液,采用ELISA法测定其尿decorin水平。肾脏病理损伤采用Katafuchi半定量积分的标准,根据肾损伤积分分为3组:肾病理损伤轻微26例(Ⅰ组);肾病理中度损伤16例(Ⅱ组);肾病理重度损伤7例(Ⅲ组)。应用SPSS11.5软件进行统计学分析。结果患儿尿decorin水平[Ⅰ组:(5.624±0.889)μg/L,Ⅱ组:(33.006±3.568)μg/L,Ⅲ组:(76.800±9.012)μg/L],随肾损伤程度的增加而显著增加(P<0.01)。3组患儿尿微量清蛋白比较无显著性差异(P>0.01)。Ⅲ组患儿尿β2-微球蛋白(β2-MG)水平[(2 034±668)μg/L]与Ⅰ、Ⅱ组[(769±213)、(656±260)μg/L]比较差异显著(P<0.05)。尿decorin水平与肾损伤程度呈显著正相关(r=0.937 P<0.01),尿decorin水平与肾小管损伤程度呈显著正相关(r=0.909 P<0.01),尿decorin水平与肌酐清除率呈显著负相关(r=-0.415 P<0.01),尿β2-MG水平与肾小管损伤程度呈正相关(r=0.347 P<0.05)。结论尿decorin水平可间接判定肾脏病理损伤的轻重。随着肾脏病理损伤程度的增加,尿decorin水平亦升高。检测尿decorin水平可作为判断肾脏病理损伤程度的临床指标之一。Objective To explore the excretion of urine decorin in children with kidney disease and its correlation with the renal damage. Methods Forty - nine children who were admitted into hospital with kidney disease from Sep. 2006 to Dec. 2007 were investigated. Twenty- four hours urine and clinical parameters were collected. Urine decorin was detected by enzyme linked immunosorbent assay （ELISA）. Katafuchi semi- quantitative scoring system was used to evaluate the renal damage. The children were classified into 3 groups according to the renal damage：group Ⅰ including 26 cases with mild damage ;group Ⅱ including 16 cases with moderate damage;and group Ⅲ including 7 cases with severe damage. SPSS 11.5 software was used to analyze the data. Results The levels of urine decorin were ： （5. 624 ± 0. 889） μg/L in group Ⅰ , （33. 006 ±3. 568）μg/L in group Ⅱ ,and （76. 800 ±9. 012）μg/L in group Ⅲ ,respectively. The levels of urine decorin were increased with the severity of renal damage （ P 〈 0.01 ）. There was no difference of urine albumin excretion among 3 groups （ P 〉 0.01 ）. The levels of urine 132 - microglobulin （ β2 - MG） were （769± 213 ） μg/L in group Ⅰ, （656 ± 260 ）μg/L in group Ⅱ , （ 2 034 ± 668 ） μg/L in group Ⅲ, respectively. There was significant difference among 3 groups （ P 〈 0.05 ）. The levels of urine decorin were positively correlated with renal damage（r =0.937 P〈0.01） and renal tubule damage （r=0.909 P〈0.01）. A negative correlation was found between the levels of urine decorin and the blood creatinine clearance rate（ r = 0. 415 P 〈 0.01 ）. The levels of urine β2 - MG were positively correlated with renal damage （ r = 0. 347 P 〈 0.05 ）. Conclusions The levels of urine decorin can act as the clinical marker of renal damage. With the severity of renal lesions, the levels of urine decorin were increased.

关 键 词：核心蛋白聚糖 肾脏病理损伤 微量清蛋白 Β2-微球蛋白 儿童 

分 类 号：R726.9[医药卫生—儿科]