肾病综合征与术后胃瘫综合征患者ALB及胆红素的对比分析  

Comparative analysis of albumin and bilirubin levels in patients with nephrotic syndrome and postoperative gastroparesis syndrome

作　　者：隋洪帅[1] 谢永新[1] 王明翠[1] 颜妍[1] 杨丹[1] 马路[1] 宋明辉[1] 

机构地区：[1]北京军区北戴河疗养院肾脏病科,全军肾病中西医结合治疗中心,河北秦皇岛066100

出　　处：《军事医学》2015年第12期944-947,951,共5页Military Medical Sciences

摘　　要：目的低蛋白血症是肾病综合征(nephrotic syndrome,NS)患者的典型特征之一,其原因可能与大量蛋白随尿液丢失有关。而低胆红素血症亦为NS患者常见临床症状。为揭示二者间的关系,该研究对NS、慢性肾小球肾炎(chronic glomerulonephritis,CGN)及术后胃瘫综合征(postoperative gastroparesis syndrome,PGS),白蛋白(albumin,ALB)<35 g/L患者的胆红素、ALB及24 h尿蛋白定量进行了对比研究。方法选取NS 187例、原发性CGN 70例、PGS(ALB<35 g/L)64例,检测ALB、尿蛋白(urinary protein,UPR)、尿微量白蛋白/肌酐(urinary microalbuminuria/creatinine,Umalb/cr)及总胆红素(TBIL),应用SPSS 17.0软件分析组间差异及TBIL与UPR、ALB的相关性。结果NS组、CGN组及PGS组人群TBIL、ALB、UPR及Umalb/Cr水平存在显著差异(one-way ANOVA test,P<0.05),且NS组和CGN组TBIL与ALB均呈正相关,TBIL与UPR及Umalb/Cr均呈负相关(Spearman's rho test,P<0.05);但PGS组上述观察指标间未见相关性(Spearman's rho test,P>0.05)。结论 NS患者血胆红素低水平与血ALB水平呈正相关,与尿蛋白、微量ALB水平呈负相关;且PGS及CGN患者对照比较,PGN患者血胆红素与血ALB没有关联性。结果表明,NS患者低血胆红素的原因可能为部分胆红素随尿蛋白的排出而丢失所致。Objective Hypoalbuminemia is a typical symptom of nephrotic syndrome（ NS）,which may result from the loss of much protein with urine. Hyperbilirubinemia is also a common symptom in patients with NS. This study is intended to reveal the relationship between hypoalbuminemia and hyperbilirubinemia in patients with NS by investigating urine bilirubin,albumin（ ALB） and 24-hour urine protein in the NS group,chronic glomerulonephritis（ CGN） group and postoperative gastroparesis syndrome（ PGS） group（ ALB 35 g / L）. Methods Totally 187 patients with NS,70 patients with CGN and 64 patients with PGS（ ALB 35 g / L） were recruited before ALB,urinary protein（ UPR）,urinary microalbuminuria / creatinine（ Umalb / cr） and total bilirubin（ TBIL） were detected. SPSS 17. 0 Software was used to analyze the difference between the three groups and to reveal the correlations between TBIL and UPR,ALB. Results TBIL,ALB,UPR and Umalb / Cr levels were significantly different between NS,CGN and PGS groups（ one-way ANOVA test,P 0. 05）,and TBIL was positively correlated with ALB but negatively correlated UPR and Umalb / Cr in both NS and CGN groups（ Spearman＇s rho test,P 0. 05）; but no correlation was found between these items in PGS group（ Spearman＇s rho test,P 0. 05）. Conclusion Serum bilirubin of patients with NS is at a low level and shows significant correlations with serum albumin and urinary protein levels. No similar association is found with the other two groups. The results in this study show that the causes of low serum bilirubin in patients with NS may related to the large amount of protein lost in urine.

关 键 词：肾病综合征 胃瘫综合征 白蛋白 胆红素 

分 类 号：R692[医药卫生—泌尿科学]