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目的 :通过测定成人原发性肾病综合征患者尿RBP和NAG ,了解患者肾小管功能与肾病综合征激素治疗效果之间的关系。方法 :测定成人原发性肾病综合征患者治疗前和激素治疗 8周后尿RBP和NAG含量 ,根据治疗后尿蛋白水平将患者分为未缓解、部分缓解和完全缓解 3组并与正常人作为对照 ,比较各组间治疗前后肾小管功能指标变化。结果 :①各病例组间治疗前尿RBP ,NAG和蛋白质水平差异无显著 (P >0 .0 5 ) ;②激素治疗有效者 ,尿中RBP和NAG明显降低 ,与治疗前比较 ,差异有显著性 (P <0 .0 1) ;③三组肾病综合征患者之间治疗后尿蛋白、RBP和NAG比较 ,差异有显著性 (P <0 .0 1)。结论 :尿RBP可预测成人原发性肾病综合征患者激素敏感性 ,且效果优于NAG。
OBJECTIVE: To determine the relationship between tubulointerstitial function and hormone therapy in nephrotic syndrome by measuring urinary RBP and NAG in patients with adult primary nephrotic syndrome. Methods: Urinary RBP and NAG levels were measured before treatment and 8 weeks after steroid treatment in adults with primary nephrotic syndrome. According to the level of urinary protein after treatment, the patients were divided into three groups: non-remission, partial remission and complete remission. The control group compared the change of renal tubular function before and after treatment. Results ① There was no significant difference in RBP, NAG and protein levels before treatment in all the cases (P> 0.05); ②The effective rate of RBP and NAG in urine was significantly lower than that before treatment, the difference was significant (P <0.01). ③ There was significant difference in urinary protein, RBP and NAG between the three groups of nephrotic syndrome patients after treatment (P <0.01). Conclusion: Urinary RBP can predict the hormone sensitivity of adult patients with primary nephrotic syndrome and its effect is better than that of NAG.