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目的:分析几种常见的肾脏功能指标分别与肾小球硬化的相关性,探讨几种常见的肾脏功能指标对预测慢性肾病患者肾小球硬化程度的价值。方法:选择2007年9月至2008年3月期间在中南大学湘雅二医院肾病内科住院的95例慢性肾脏病患者。收集所有患者的一般资料及实验室检查资料,其中肾脏功能评价指标包括据改良的简化MDRD公式估算的eGFR、血清β2微球蛋白(β2-MG)、血清肌酐(Scr)。95例患者均于住院期间行肾脏穿刺活检术并确诊为原发性肾小球肾炎,取患者肾组织,光镜下定量测量出每例患者肾小球硬化相对面积[肾小球毛细血管襻硬化面积占肾小球毛细血管襻总面积的百分比(Rg)]。将各肾功能指标与肾小球硬化相对面积进行相关性分析。结果:eGFR与Rg均存在高度负相关关系;β2-MG、Scr与Rg均存在正相关关系。结论:原发性肾小球肾炎所致CKD患者的肾脏功能改变与肾脏病理肾小球硬化程度具平行关系。肾功能指标改变eGFR、β2-MG、Scr均可用以预测肾脏病理肾小球硬化程度,其相关系数依次由高到低。
OBJECTIVE: To analyze the correlation between several common renal function indexes and glomerulosclerosis, and to explore the value of several common renal function indexes in predicting the degree of glomerulosclerosis in patients with chronic kidney disease. Methods: Ninety-five patients with chronic kidney disease who were hospitalized in Department of Nephrology, Second Xiangya Hospital of Central South University from September 2007 to March 2008 were selected. General information and laboratory tests were collected for all patients. The renal function assessment included eGFR, serum β2-microglobulin (β2-MG) and serum creatinine (Scr) as estimated using the modified simplified MDRD formula. Ninety-five patients underwent renal biopsy during hospitalization and were diagnosed as primary glomerulonephritis. The kidney tissues were taken and the relative area of glomerular sclerosis was quantified by light microscopy [glomerular capillary loop Percentage of sclerosing area to total area of glomerular capillaries (Rg)]. The correlation between renal function indexes and glomerular sclerosis relative area was analyzed. Results: There was a highly negative correlation between eGFR and Rg. There was a positive correlation between β2-MG, Scr and Rg. Conclusion: There is a parallel relationship between renal function changes and renal pathological glomerulosclerosis in CKD patients with primary glomerulonephritis. Changes in renal function indicators eGFR, β2-MG, Scr can be used to predict the extent of renal pathological glomerulosclerosis, the correlation coefficient in turn from high to low.