高原地区原发性肾病综合征肾小管功能损害及预后的关系  

RELATIONSHIP OF RENAL TUBULAR INSUFFICIENCY AND PROGNOSIS IN PAT IENTS WITH PRIMARY NEPHROTIC SYNDROME AT HIGH ALTITUDE

作　　者：陈彬[1] 李丽[2] 梅小兵[3] 邹密[1] 黄浩[1] 李景华[1] 李川[1] 罗宗[1] 朱家曙 

机构地区：[1]西藏军区总医院心肾内科,850003 [2]西藏军区总医院心胸血管外科,850003 [3]上海第二军医大学上海医院肾内科,200433 [4]西藏林芝大站卫生队

出　　处：《高原医学杂志》2002年第1期14-16,共3页Journal of High Altitude Medicine

摘　　要：目的 :探讨高原地区 (海拔 3 680m)原发性肾病综合征 (PNS)肾小管功能损害及与泼尼松疗效的关系 ;方法 :PNS患者经泼尼松 1mg (kg·d)正规治疗 8周后根据疗效分为有效组 (n =3 8)和无效组 (n =1 2 ) ,与泼尼松治疗前后对 50例高原地区PNS患者酶联免疫法测定尿视黄醇结合蛋白 (RBP)及N -乙酰 -β-D氨基葡萄糖苷酶 (NAG)、冰点法测定次晨尿渗透压、磺基水杨酸比浊法测定 2 4小时尿蛋白量、碱性苦味酸法测定血清肌酐 ;结果 :①高原地区PNS患者泼尼松治疗前尿RBP( 0 .54± 1 .1 9)mg L、NAG( 1 1 2 .84± 42 .82 )u L及次晨尿渗透压 ( 553 .62± 2 48.91 )mosm L ,与正常对照组间有显著差异 (P <0 .0 1 ) ;②有效组与无效组相比 ,泼尼松治疗前尿RBP( 0 .3 3± 0 .1 6或 0 .68± 0 .1 4 )mg L、NAG( 97.46± 3 2 .53或 1 58.65± 1 2 .98)u L及次晨尿渗透压 ( 61 9.45± 48.92或 3 3 7.81± 2 6.56)mosm L差别有显著性 (P <0 .0 1 ) ,而 2 4小时尿蛋白定量、血清肌酐差别无显著性 (P >0 .0 5) ;③有效组治疗后尿RBP、NAG及渗透压恢复正常 ,而无效组无明显变化 ;结论 :高原地区PNS存在肾小管功能损害 。To observe the relationship of renal tubular insufficiency and treatment with prednisone in patients with primary nephritic syndrome (PNS) at high altitude. Methods: The PNS patients (34 men and 16 women, age arrange from 17 to 32 year old), who had been treated regularly with prednisone (1mg/kg.d) for 8 weeks, were divided into effective and ineffective group. The level of RBP and NAG in urine were determined by ELISA while the level of osmosis, 24 hr urinary protein excretion and serum creatine were measured and compared them with normal control. Results: There was a remarkable difference (P<0.01) between the control and PNS on RBP, NAG and urinary osmosis before treatment with prednisone. There was a obvious difference (P<0.01) between effective and ineffective group on RBP, NAG and urinary osmosis before treatment, no difference on the level of 24 hr urinary protein and serum creatine(P>0.05). The level of RBP, NAG and urinary osmosis returned to normal level in effective group after treatment with prednisone, no changes in ineffective group under same condition. Conclusion: The prognosis of patients had been treated by prednisone could associated with renal tubular damage as well as the severity in patients with primary nephrotic syndrome.

关 键 词：高原 原发性肾病综合征 肾小管功能 预后 

分 类 号：R692[医药卫生—泌尿科学]