【摘要】 目的探讨原发性肾小球肾炎患者尿蛋白定量与骨转化标志物的相关性。方法回顾性分析2012-2014年大连医科大学附属第一医院经肾组织活检确诊为原发性肾小球肾炎患者80例,按照基线尿蛋白定量分3组,A组:24 h尿蛋白定量<1g;B组:1.0 g≤24 h尿蛋白定量≤3.5 g;C组:24 h尿蛋白定量>3.5 g。记录患者的性别、发病年龄、病程、用药情况。所有研究对象均测定基线、治疗6月时血清Ca、P、ALP、25(OH)D、β-CTX、t PINP、N-MID、CT、i PTH水平,并检测相应时间点血清肌酐和白蛋白水平;同时检测基线和治疗6月时脊柱和股骨头骨密度。结果 3组患者一般情况比较,A、B、C 3组患者血清ALB有明显下降趋势,血清ALB在各组之间比较均有统计学意义(P<0.05)。血清Cre、Urea在各组间比较有上升趋势,血清Cre在C组与A组比较明显升高(P<0.05),血清Urea在B组与C组比较明显升高(P<0.05),差异均有统计学意义。3组患者血清25(OH)D的比较,25(OH)D有明显下降趋势,且A组与B组、A组与C组比较差异均有统计学意义(P<0.05),不同蛋白尿组患者血清Ca、ALP、i PTH、N-MID、t PINP、β-CTX在各组间比较均无明显统计学意义。3组患者骨密度值的比较,腰椎T值、腰椎BMD、股骨颈T值、股骨颈BMD随着蛋白尿的增多,均有下降趋势,腰椎BMD在C组与A组比较,明显降低,差异有统计学意义(P<0.05)。尿蛋白定量与骨转化标志物的相关性比较,Cox回归表明尿蛋白定量与血清25(OH)D水平呈负相关,与Ca、ALP、i PTH、N-MID、t PINP、β-CTX无关。结论原发性肾小球肾炎患者尿蛋白定量与血清25(OH)D水平呈负相关。更多还原

【Abstract】 Objective To explore the correlation of urinary albumen quantification and osteoblast proliferation markers in the patients of primary glomerulonephritis.Me thod Eighty cases of primary glomerulonephritis diagnosed by renal biopsy were analysed retrospectively in First Affiliated Hospital of Dalian Medical University during 2012-2014,they were divided into three groups according to the baseline of urinary albumen quantification,A:24 h urinary albumen quantification < 1.0 g;B:1.0 g ≤24 h urinary albumen quantification≤3.5 g;C:24 h urinary albumen quantification > 3.5 g.we recorded the patients’ sex,morbidity age,the course of the disease,and medications.All the research subjects have already been measured the baseline,the serum Ca、P、ALP、25( OH) D、β-CTX、t PINP、N-MID、CT、i PTH levels treatment after three and six months,the serum creatinine and albumin levels at each time point,the baseline and bone density of spine and femoral head treatment after six months.Re sult serum Ca and ALB in all the patients with albuminuria were decreased obviously,serum ALB level between A and B,A and C,B and C had statistical signification( P < 0.05),there was no significant difference about serum Ca level in all the groups.Serum Cre and Urea levels were notably increased,serum Cre in group C had increased obviously compared with A( P < 0.05),while serum Urea in group B had markedly raised compared with C( P < 0.05).There was no significant difference about the serum UA、ALP、i PTH in each group.Serum 25( OH) D level in different urinary albumen groups had been notably decreased,there was statistical signification between A and B,A and C( P < 0.05).There was no significant difference about serum N-MID、t PINP、β-CTX level in all the groups.With the increase of urinary albumen,all the lumbar vertebrae T value and BMD,femoral neck T value and BMD were decreased,lumbar vertebrae BMD was clearly decreased and had the statistical signification in group C compared with A( P <0.05).Conclusion Urinary albumen quantification is negatively related to serum 25( OH) D in patients of primary glomerulonephritis.更多还原