各型紫癜性肾炎尿系列酶变化及相关因素分析  

Changes of urine enzyme series and analysis of the related factors in 4 clinical types of purpuric nephritis

作　　者：雷晓燕[1] 熊海金[1] 张宏[1] 赛依帕[1] 王建军[1] 

机构地区：[1]甘肃省人民医院儿科,甘肃兰州730000

出　　处：《实用儿科临床杂志》2004年第1期18-20,共3页Journal of Applied Clinical Pediatrics

基　　金：甘肃省中青年自然基金项目 (YS991 -A2 3 - 0 2 1 )

摘　　要：目的　通过尿系列酶 [N Z酰 β D氨基葡萄糖苷酶 (NAG)、γ 谷氨酰转移酶 (GGT)、碱性磷酸酶(ALP)、β 半乳糖苷酶 (GAL) ]的检测 ,探讨紫癜性肾炎 (HSPN)临床各型的肾小管受损程度及肾小管与肾小球损害之间的相关性。方法　 1.按照日本田博义对HSPN的分型法将本病分为临床 4型 ,其中Ⅰ型 2 4例、Ⅱ型 2 0例、Ⅲ型 2 0例、Ⅳ型 10例 ;2 .采用碱性苦味酸速率法对 74例HSPN患儿及 2 5例正常对照组患儿行尿系列酶检测 ,同时测定血肌酐 (BCr)及尿素氮 (BUN)做对照 ;3.分析临床各型尿酶变化及其与肾小球功能改变的关系。结果　HSPN临床 4型与对照组相比 ,尿系列酶均有不同程度改变。尿酶排量从高到低排列顺序依次为 :Ⅳ型 >Ⅲ型 >Ⅱ型 >Ⅰ型 >对照组 ;Ⅲ、Ⅳ型出现肾小球功能改变 (BUN、BCr含量增高 )时 ,尿酶排量增高更为明显。结论　尿系列酶可敏感地反映肾小管功能的早期受损。BUN及BCr含量既使在正常范围 ,尿酶含量已有变化 ,提示已有肾小管功能损害 ;当BUN及BCr出现异常改变时 ,尿酶改变更为突出。即BUN、BCr含量与尿酶排量呈正相关关系 ,尿酶排量越高 ,肾小管功能受累越明显 。Objective To monitor the damage extent to renal tubules by detecting urine enzyme series such as N-aletyle-β-D-glu cosaminedase(NAG),gamma glutamy transferase(GGT),alkalime phosphatase(ALP),galactosidase(GAL),and to explore the relationship between damage extent to renal tubules and renal globes in various clinical types of purpuric nephritis(HSPN).Methods Seventy-four patients were divided into 4 groups, of which 24 cases were type I, 20 cases were type Ⅱ, 20 cases were type Ⅲ,and 10 cases were type Ⅳ. All the patients and 25 cases of normal children regarded as control group were detected with series urine enzyme analysis,Blood creatinine(BCr) and bload area nitrogen(BUN) were also been detected stimultaneously. Results Compared with control group, there were more or less changes of urine enzyme series in various types of HSPN, the drainage quantity of the enzymes was ranked as type Ⅳ>type Ⅲ>type Ⅱ>type Ⅰ>control group from the high to the low. When the typeⅢand type Ⅳglomerular function was changed (BUN and BCr in high value),the drainage quantity of the enzymes evidently increased.Conclusions Urine enzyme series can sensitively reflect the damage of renal tubules in early stage, even if BUN and BCr value is on the normal level , and the drainage quantity of these enzymes are changed more or less, which show that renal tubule damage exists. The value of BUN and BCr is positively correlated with the drainage quantity of these enzymes.the more urine enzymes are drained out, the more renal tubule function is involved, therefore, the more renal globe function is damaged.

关 键 词：肾炎 紫癜性 尿酶 肾小球 肾小管 功能 

分 类 号：R726.9[医药卫生—儿科]