【作者】 赵爱萍；

【导师】 王智；

【作者基本信息】 福建中医学院 ， 中西医结合临床， 2006， 硕士

【摘要】 目的：探讨慢性肾炎患者血、尿纤维结合蛋白(FN)的水平变化及其与中医证型之间的关系，观察各型之间不同的血、尿FN水平，为慢性肾炎中医辨证标准化提供一量化的思路。探讨血、尿FN水平与肾脏病理的关系，为肾脏纤维化的早期发现、治疗提供一较可靠的临床检测指标。 方法：根据中华内科杂志编委会专业组于1992年拟订的慢性肾炎诊断标准，取慢性肾炎患者做为本课题的研究对象。1．采用双抗体夹心酶联免疫吸附(ELISA)法测定87例慢性肾炎患者和25例健康人的血、尿FN含量。2．观察血、尿FN水平与中医证型的关系。3．其中有59例慢性肾炎患者进行肾活检病理检查，观察其血、尿FN水平与肾脏病理改变的关系。 结果：1．与健康组相比，慢性肾炎组患者血FN水平降低，尿FN水平增高(P＜0.01)。 2．各中医证型的血FN组间比较，无显著差异。尿FN水平在各中医证型中差异非常显著(P＜0.01)。气阴两虚组与脾肾气虚组、肺肾气虚组、肝肾阴虚组比较，尿FN明显增高(P＜0.01)，而脾肾气虚组、肺肾气虚组、肝肾阴虚组两两比较差异不显著。 3．血FN在肾小球硬化0级组、1级组、2级组及健康组之间无显著差异。而硬化3级组与健康组比较，血FN明显降低(P＜0.01)，差异非常显著，与0级组、2级组比较，差异显著(P＜0.05)，与1级组比较无显著差异。硬化0级组与健康组比较，尿FN升高，差异显著(P＜0.05)。硬化1级组、2级组、3级组与健康组比较，尿FN升高，差异非常显著(P＜0.01)。尿FN在0级组、1级组、2级组之间差异显著，呈递增趋势。而硬化3级组与2级组比较，尿FN无显著差异。肾小球硬化程度与血FN水平负相关，与尿FN水平正相关，r值分别为-0.393(p＜0.01)，0.827(p＜0.01)，相关显著。 4．血FN在肾间质纤维化0级组、1级组及健康组之间无显著差异。纤维化2级组较健康组，血FN明显降低，(P＜0.01)，差异非常显著，较0级组、1级组，血FN降更多还原

【Abstract】 Objective: 1.To study the relationship between the contents change of serum ,urinary Fibronectin(FN) and the syndrome of TCM in Chronic Glomerulonephritis, provides a quantification method for the Chinese medicine dialectical standardization of Chronic Glomerulonephritis.To discuss the relationship between the contents change of serum ,urinary FN and the renal pathology in Chronic Glomerulonephritis, provides a reliable clinical examination indicatrix for the the early discovery and the treatment of renal fibrosis.Materials and Methods:The Chronic Glomerulonephritis patient was the object according to the diagnose standard of the Chinese internal medicine department magazine in 1992. 1.The contents of serum,urinary FN in 87 chronic glomerulonephritis patients and 25 healthy person were measured respectively by two-layer antibody sandwich enzyme-linked immunoad sorbent assay(ELISA) method. 2. To study the relationship between the contents change of serum ,urinary FN and the syndrome of TCM. 3. Among them,59 cases of chronic glomerulonephritis patients were carried on renal biopsy pathology inspection to observe the relationship between the content change of serum ,urinary FN and the change of renal pathology in Chronic Glomerulonephritis.Result: 1.Compared with healthy group , the Serum FN level decreased in the chronic glomerulonephritis group (p < 0.05),the urinary FN level increased obviously(p < 0.01);2. The level of serum FN did not have significantly difference among various TCM syndromes in.The urinary FN level had remarkable difference in various TCM syndromes(p < 0.01). Compared with the other TCM syndromes ,the content change of the urinary FN level更多还原