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目的 探讨肾小管功能检测在IgA肾病 (IgAN)中的临床意义。方法 分析 32例IgAN患者的临床与病理资料 ,探讨肾小球及间质病理损害程度与肾小管功能 (尿NAG酶、尿LYS及尿渗透压 )的关系。结果 肾小管间质损害情况 :肾小管间质损害轻度者占 4 3 8% ( 1 4 / 32 ) ,中重度者占 34 4 % ( 1 1 / 32 ) ,无肾小管间质肾损害者2 1 9% ( 7/ 32 )。肾小管间质损害与肾小管功能的关系 :肾小管间质损害中、重度者尿NAG酶 ( 4 2 7± 2 4 1 )U/ (mmol·cr)、尿渗透压 ( 4 99 6 1± 1 2 4 6 7)mOSM/ (kg·H2 O) ;肾小管间质损害轻度者尿NAG酶 ( 1 75± 0 5 4 )U/ (mmol·cr) ,尿渗透压 ( 6 5 3 92± 2 4 1 86 )mOSM/ (kg·H2 O) ;无肾小管间质肾损害者尿NAG酶 ( 1 5 3± 0 4 3)U/ (mmol·cr) ,尿渗透压 ( 783 35± 1 6 3 4 3)mOSM/ (kg·H2 O)。肾小管间质中重度损害者同其他两组比较 ,其尿NAG酶及尿渗透压差异有显著性 (P <0 0 5 ) ;尿LYS在各组之间差异无显著性 (P >0 0 5 )。结论 常合并肾小管间质损害 ,肾小管功能中尿NAG酶及尿渗透压改变与肾脏肾小管间质损害程度成对应关系。
Objective To investigate the clinical significance of renal tubular function test in IgA nephropathy (IgAN). Methods The clinical and pathological data of 32 patients with IgAN were analyzed to explore the relationship between the degree of glomerular and interstitial pathological damage and renal tubular function (urine NAG enzyme, urine LYS and urine osmotic pressure). Results Tubulointerstitial damage: mild tubulointerstitial injury accounted for 43.8% (14/32), moderate to severe 34.4% (11/32), no renal tubulointerstitial damage 2 1 9% (7/32). The relationship between tubulointerstitial damage and renal tubular function: Among the severe tubulointerstitial damage, the urinary NAG enzyme (42 7 ± 241) U / (mmol · cr), urine osmolality (4 99 6 1 ± 1 24 7 7) mOSM / (kg · H 2 O); urinary NAG enzyme (1 75 ± 0 5 4) U / (mmol · cr), urinary osmotic pressure (6 5 3 92 ± 2 4 1 86) mOSM / (kg · H 2 O); urine NAG enzyme (153 ± 0 4 3) U / (mmol · cr), urine osmolality (783 35 ± 1 6 3 4 3) mOSM / (kg · H 2 O). Compared with the other two groups, there was significant difference in urinary NAG and urine osmolality (P <0.05), but no significant difference in urinary LYS between the groups (P> 0 0) 5). Conclusions Often associated with tubulointerstitial damage, renal tubular function of urinary NAG enzyme and urinary osmolality and renal tubulointerstitial damage degree of the corresponding relationship.