运用尿NAG酶和RBP评价儿童紫癜性肾炎肾小管损伤特点  

An evaluation on the characteristics of renal tubule injury in children with purpura nephritis by urinary N-acetyl-β-d-glucosaminidase and retinol-binding protein

作　　者：李金刚[1] 黄岩杰[1,2] 白梦刻 梅晓峰[1] 杨晓青[1] 张秋爽 LI Jin-gang;HUANG Yan-jie;BAI Meng-ke;MEI Xiao-feng;YANG Xiao-qing;ZHANG Qiu-shuang(Department of Pediatrics,the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Henan 450000,China;不详)

机构地区：[1]河南中医药大学第一附属医院儿科,河南450000 [2]河南中医药大学儿科医学院

出　　处：《中国卫生检验杂志》2023年第5期513-515,共3页Chinese Journal of Health Laboratory Technology

基　　金：2021年度国家自然科学基金面上项目(82174187);河南省中医药学科领军人才项目(豫卫中医函[2021]8号);河南省特色骨干学科中医学学科建设项目(STG-ZYXKY-2020008)。

摘　　要：目的 探讨不同水平蛋白尿的紫癜性肾炎(HSPN)患儿肾小管的损伤特点。方法 选取本院2019年1月—2021年6月收治的283例HSPN患儿,根据24 h尿蛋白(24 h UP)水平分为轻度蛋白尿组155例、中度蛋白尿组66例、重度蛋白尿组62例,同时选取36例正常儿童,56例单纯过敏性紫癜(HSP)患儿作为对照。用胶乳增强免疫比浊法检测尿N-乙酰β-D-氨基葡萄糖苷酶(NAG)和视黄醇结合蛋白(RBP)水平,所有结果均与尿肌酐相比进行校正,统计分析HSPN每组数据高于正常值的异常率,并对比分析以上5组尿NAG酶和RBP差异水平。结果 HSPN轻度蛋白尿组NAG酶异常率为17%,RBP异常率为82%;中度蛋白尿组NAG酶异常率为35%,RBP异常率为86%;重度蛋白尿组NAG酶异常率为63%,RBP异常率为89%。随着24 h UP的增加,HSPN患儿尿中NAG酶和RBP的水平均逐步升高,轻、中、重蛋白尿组差异有统计学意义(P<0.05),其中尿RBP在不同水平蛋白尿组异常率相近,但定量检测尿RBP的水平随着蛋白尿的加重而增加。结论 尿NAG酶和RBP可分别从肾小管上皮细胞受损和重吸收功能障碍2个方面反映不同水平蛋白尿的HSPN患儿肾小管损伤特点,尿RBP是反映HSPN患儿肾小管损伤的敏感指标。Objective This paper aims to explore the features of renal tubular damage in children with Henoch-Sch9nlein purpura nephritis(HSPN) at different levels of proteinuria. Methods A total of 283 children with HSPN admitted to our hospital from January 2019 to May 2021 were selected. According to 24 hour urine protein(24 h UP) level, there were 155 cases of mild proteinuria, 66 cases of moderate proteinuria, and 62 cases of severe proteinuria. Meanwhile, 36 normal children and 56 children with HSP were used as controls. The levels of N-acetyl-β-d-glucosaminidase(NAG) and retinol-binding protein(RBP) were determined by latex enhanced immunoturbidimetry. All results were corrected for comparison with urinary creatinine. The abnormal rate of NAG and RBP in each group of HSPN higher than normal value was statistically analyzed, and the difference of urinary NAG enzyme and RBP in the above 5 groups were compared and analyzed. Results The abnormal rates of NAG enzyme and RBP were 17% and 82% in the HSPN mild proteinuria group respectively. The abnormal rates of NAG enzyme and RBP were 35% and 86% in the moderate proteinuria group respectively. The abnormal rates of NAG enzyme and RBP were 63% and 89% in the group with severe proteinuria. With the increase of 24 h UP, the levels of NAG enzyme and RBP in urine of HSPN children were gradually increased, and there was statistical significance on the differences among the groups with mild, moderate and severe proteinuria(P<0.05). The abnormal rates of urinary RBP were similar in groups with different levels of proteinuria, but the level of urinary RBP significantly increased with the aggravation of proteinuria. Conclusion Urinary NAG enzyme and RBP can reflect the characteristics of renal tubule injury in children with HSPN with different levels of proteinuria from two aspects of tubular epithelial cell damage and reabsorption dysfunction respectively. Urinary RBP is a sensitive indicator of renal tubule injury in children with HSPN.

关 键 词：紫癜性肾炎 肾小管损伤 NAG酶 视黄醇结合蛋白 

分 类 号：R587.1[医药卫生—内分泌]