IgA肾病患者血浆不对称二甲基精氨酸与肾脏病理损伤的相关性

发布时间：2019-05-09 11:33

【摘要】：目的分析不对称二甲基精氨酸(ADMA)作为生物标志物在Ig A肾病诊治中应用的可行性。方法选取经肾活检证实的Ig A肾病患者82例,由体检中心选取健康志愿者28例作为对照组,所有对象抽取空腹血测量血浆ADMA、血脂、尿素氮(BUN)、肌酐(Scr)、尿酸(UA)和蛋白尿(UP)水平。肾组织行HE染色,采用肾小球损伤评分及肾间质、小管损伤评分评价肾脏病理损伤程度。结果 Ig A肾病组与对照组相比,总胆固醇、甘油三酯水平明显升高;血肌酐、ADMA水平明显升高,e GFR水平明显减低(均P0.01)。Ig A肾病组ADMA与Scr、UP呈显著正相关,与e GFR呈显著负相关;多元线性回归显示ADMA与Scr呈正相关(β=0.343,P0.01),与UP呈正相关(β=0.331,P0.01),与e GFR呈负相关(β=-0.346,P0.01)。血浆ADMA与肾小球损伤评分(β=0.050,P0.01)、肾间质小管损伤评分(β=0.358,P0.01)呈显著正相关。结论 Ig A肾病患者在e GFR未发生明显下降的时期,血清ADMA已出现明显升高,ADMA可能作为评价Ig A肾功能的指标和反映肾脏病理损伤程度的指标。
[Abstract]:Objective to analyze the feasibility of asymmetric dimethylarginine (ADMA) as a biomarker in the diagnosis and treatment of Ig-A nephropathy. Methods 82 patients with Ig A nephropathy confirmed by renal biopsies were selected and 28 healthy volunteers were selected as control group. Fasting blood samples were taken to measure plasma ADMA, blood lipids and urea nitrogen (BUN), creatine (Scr),. Uric acid (UA) and proteinuria (UP) levels. Renal tissue was stained with HE. Glomerular injury score, renal interstitial injury score and tubule injury score were used to evaluate the degree of renal pathological injury. Results compared with the control group, the levels of total cholesterol and triglyceride in the Ig-A nephropathy group were significantly higher than those in the control group. The levels of serum creatinine and ADMA increased significantly and the level of, e GFR decreased significantly (P0.01) in). Ig A renopathy group, ADMA was positively correlated with Scr,UP, and negatively correlated with e-GFR. Multiple linear regression showed that ADMA was positively correlated with Scr (尾 = 0.343, P0.01), positively correlated with UP (尾 = 0.331, P0.01), and negatively correlated with e-GFR (尾 =-0.346, P0.01). Plasma ADMA was positively correlated with glomerular injury score (尾 = 0.050, P0.01) and renal interstitial tubule injury score (尾 = 0.358, P0.01). Conclusion in patients with Ig A nephropathy, serum ADMA has increased significantly in the period when e-GFR did not decrease significantly. ADMA may be used as an index to evaluate the renal function of Ig A and to reflect the degree of renal pathological injury.
【作者单位】：河北省人民医院肾内科;邯郸市中心医院肾内科;
【基金】：河北省科技支撑计划项目(No.12276104D-85)
【分类号】：R692.31

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