尿肾损伤分子1与原发性肾小球肾炎肾小管间质病变相关性研究  

Study on the correlation of urinary kidney injury molecular-I and tubulointersfitial lesions in patients with primary glomerulonephritis

作　　者：张蓓茹[1] 白瑜[1] 于锐[1] 边晓慧[1] 李德天[1] 

机构地区：[1]中国医科大学附属盛京医院肾内科,沈阳110004

出　　处：《中国医师杂志》2013年第12期1601-1604,共4页Journal of Chinese Physician

基　　金：辽宁省自然科学基金（201102272）

摘　　要：目的观察原发性肾小球肾炎患者尿肾损伤分子1（KIM-1）水平及其相关因素，明确其在原发性肾小球肾炎患者中的临床意义。方法纳入2009年7月至2011年4月在盛京医院住院行肾穿刺活检诊断原发性肾小球肾炎患者125例，根据肾小管间质病变程度分为4组，观察各组患者临床情况、生化指标及尿KIM-1水平，同时分析影响尿KIM-1水平的相关因素。结果肾小管间质病变程度越重，尿KIM-1水平越高。与肾小管间质病变较轻组比较，肾小管间质病变严重组患者平均动脉压、血肌酐明显升高，估算肾小球滤过率（eGFR）水平下降。在原发性肾小球肾炎患者中，尿KIM-1水平与血清肌酐（r=0．373，P〈0．01），蛋白尿（r=0．439，P〈0．01）以及肾小管间质损伤程度（r=0．518，P〈0．01）呈正相关，与eGFR（r=-0．355，P〈0．01）、血清白蛋白（r=-0．296，P=0．01）水平呈负相关。结论尿KIM-1水平的测定可能是评估原发性肾小球肾炎患者肾小管间质损伤程度有用的生物标志物。Objective To explore the clinical significance of urinary kidney injury molecule-1 （ KIM-1 ） through the observation of the value and correlation factors of urinary KIM-1 in patients with primary glomerulonephritis. Methods A total of 125 patients with primary glomerulonephritis diagnosed by renal biopsy at the Department of Nephrology, Shengjing Hospital, during July 2009 to April 2011, was enrolled in the study. According to the degree of tubulointerstitial lesions, patients were divided into 4 groups. Clinical features, biochemical index, and the levels of urinary KIM-1 were measured. Correlation factors of urinary KIM-1 were evaluated. Results The more severe the tubulointerstitial injury was, the higher the levels of urinary KIM-1. Patients with severe tubulointerstitial lesions had higher levels of mean arterial pressure （MAP）, serum creatinine, and lower estimated glomerular filtration rate （eGFR） than those with mild tubulointerstitial lesions. Meanwhile, urinary levels of KIM-1 in patients with primary glomerulonephri- tis positively correlated with levels of serum ereatinine （ r = 0. 373, P 〈 0. 01 ）, proteinuria （ r = 0. 439, P 〈0. 01 ）, and the degree of tubulointerstitial lesions （ r =0. 518, P 〈0. 01 ） and negatively with eGFR （ r = -0.355, P 〈0.01） and serum albumin （ r = -0.296, P =0.01）. Conclusions Urinary KIM-1 might be a useful biomarker to evaluate tubulointerstitial lesions in patients with primary glomerulonephritis.

关 键 词：膜糖蛋白类 尿 肾小球肾炎 病理学 肾 病理学 肾炎 间质性 病理学 

分 类 号：R692.3[医药卫生—泌尿科学]