【摘要】 目的探讨系统性红斑狼疮(SLE)患者尿α1微球蛋白(α1-MG)、尿微量白蛋白(MA)、尿转铁蛋白(TRU)、尿免疫球蛋白G(IGU)及尿β2微球蛋白(β2-MG)检测的临床意义及其与不同病理类型狼疮肾炎(LN)的关系。方法分别采用放射散射比浊法、化学放光法测定SLE患者尿α1-MG、尿MA、TRU、IGU及尿β2-MG水平,并与健康人对照,分析尿微量蛋白水平与LN病理类型之间的关系。结果①SLE患者尿α1-MG、尿MA、TRU、IGU(P均<0.01)及尿β2-MG(P<0.05)水平均明显高于健康对照组;伴有肾损害临床表现的SLE患者5项尿微量蛋白均明显高于无肾损害临床表现的SLE患者(P<0.05);无肾损害临床表现的SLE患者5项尿微量蛋白均明显高于健康对照组(尿β2-MG,P<0.01,其余P均<0.05)。②Ⅳ型LN尿MA、TRU、IGU水平明显高于Ⅱ型LN(P<0.05),尿MA水平明显高于Ⅲ型LN(P<0.05),尿α1-MG水平明显高于Ⅴ型LN(P<0.05),Ⅴ型LN尿MA水平明显高于Ⅱ型LN(P<0.01)。结论①尿微量蛋白能反映SLE患者肾小球和肾小管双重损害及损害程度,是SLE患者早期肾损害的敏感指标。②多项尿微量蛋白检测提示不同病理类型LN的肾损伤程度不同。尿MA及α1-MG可能是反映不同病理类型LN肾损害差异的敏感指标。更多还原

【Abstract】 Objective To explore the clinical significance of urinary α1-microglobulin (α1-MG), β2-micro-globulin (β2-MG), albumin (MA), immunoglobulin G (IGU) and transferritin (TRU), and investigate the correlation between microproteinuria and renal pathological changes in patients with systemic lupus erythematosus (SLE). Methods According to the presence of nephritis, 47 SLE patients who had renal biopsy were divided into two groups: 30 patients with clinical lupus nephritis (OLN), and 17 patient with silent lupus nephritis (SLN). The urinary α1-MG, β2-MG, MA, IGU and TRU were measured in SLE patients and compared with healthy control group. The level of microproteinuria and renal biopsy pathological changes in SLE patients were studied. Results ①The levels of urinary α1-MG, β2-MG, MA, IGU and TRU had statistical differences between SLE group and healthy control group, OLN group and SLN group, SLN group and healthy control group respectively. ②The levels of urinary MA、TRU、 IGU were significantly higher in WHO class Ⅳ than in class Ⅱ LN, the level of urinary MA was markedly increased in class Ⅳ than in class Ⅲ LN and α1-MG was significantly different between class Ⅳ and Ⅴ LN. In classⅤ LN, the urinary MA was obviously increased compared with class Ⅱ LN. Conclusion ①The urinary α1-MG, β2-MG, MA, IGU and TRU reflects the severity of renal damage in SLE patients and may be used as sensitive markers for early lupus nephritis. ②The measurement of microproteinuria indicates that the difference in severity of renal damage exists among different WHO classes of LN and urinary MA and α1-MG may be sensitive indicators.更多还原