检测妊娠蛋白尿患者尿中足细胞的临床意义  

Detection of Urinary Podocytes in Patients with Pregnancy Proteinuria and Its Clinical Significance

作　　者：韦家智[1] 尹友生[1] 欧俊[1] 李清初[1] 覃源[1] 冯艳[1] 李运千[1] 

机构地区：[1]桂林医学院附属医院肾内科,广西壮族自治区桂林市541001

出　　处：《医学分子生物学杂志》2013年第3期163-166,共4页Journal of Medical Molecular Biology

摘　　要：目的探讨妊娠继发蛋白尿患者尿中足细胞的临床意义。方法选取87例妊娠晚期继发蛋白尿患者（蛋白量〉0．5g／d），采用抗人足细胞标记蛋白Podocalyxin抗体进行间接免疫荧光染色的方法对患者尿足细胞进行检测，并将其与24h尿蛋白定量，血白蛋白，肌酐清除率，平均动脉压等指标进行相关性分析。结果实验组足细胞阳性率达69％，对照组中未发现足细胞，两组间比较有统计学意义（χ^2=67．25，P〈0．01）；伴足细胞尿患者的血浆白蛋白、肌酐清除率显著低于尿足细胞阴性患者（P〈0．01）；24h尿蛋白定量、平均动脉压显著高于尿足细胞阴性患者（P〈0．01）。尿足细胞数目与24h尿蛋白定量呈正相关（r=0．357，P〈0．05）。产后3个月足细胞阴性组尿蛋白转阴率明显高于阳性组（P〈0．01）。结论检测尿足细胞是一项可反映妊娠蛋白尿患者病情轻重的无创性指标。Objective To investigate the urinary podocytes in patients with pregnancy proteinu- ria and its clinical significance. Methods The podocytes in the urinary sediments were detected by indirect immunofluorescence staining using anti-human Podoealyxin （PCX, a podocyte marker） in 87 patients with pregnancy proteinuria （ protein content 〉 0. 5 g/d） . The correlation analysis was performed between urinary podocytes and 24-hour urinary protein, serum albumin, creatinine clearance rate, or mean arterial pressure. Results The podocyte-positive rate was 69% in patients with pregnancy proteinuria, and no urinary podocytes were found in the control group （χ2 = 67.25, P 〈 0. 01 ） . The serum albumin and creatinine clearance rate were closely associated with urinary podocytes in pregrancy proteinuria （ P 〈 0. 01 ） . The 24-hour urinary protein and mean arterial blood pressure were significantly higher in podocyte-positive patient than in podocyte-negative patients （P 〈 0.01 ） . The number of urinary podoeytes was positively correlated with the 24-hour uri- nary protein （ r = 0. 357, P 〈 0. 05 ） . The urine protein negative rate was significantly higher in podocyte-negative group than in podocyte-positive group 3 months after delivery （ P 〈 0. 01 ）. Conclusion Urinary podocytes may be used as a noninvasive indicator to evaluate the severity of pregnancy proteinuria.

关 键 词：妊娠并发症 蛋白尿 足细胞 

分 类 号：R714.24[医药卫生—妇产科学]