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目的探讨原发性肾病综合征(Primary nephrotic syndrome,PNS)患者急性期蛋白与肾小球内凝血指数(Itraglomerular coagulation indexI,CI)及肾功能之间的关系,以期为防治PNS肾功能衰竭提供新的策略。方法收集我院2007年1月~2009年12月期间住院治疗的PNS患者56例,所有入选病例均为初发未经治疗的PNS患者。按ICI高低分组I,CI<0.5为L组(26例)I,CI>1.0为H组(30例)。检测尿中24h尿蛋白定量(Upro)和尿显微蛋白降解产物(FDP),用以计算ICI(ICI=Upro/FDP);检测血中C-反应蛋白(CRP)、纤维蛋白原(FIB)、C3、血清肌酐(Scr)、铁蛋白(Fe)、白介素-6(IL-6),按按Cockcroft-Gault公式计算内生肌酐清除率(Ccr),比较两组间以上指标差异,并对相关指标进行pearson分析。结果 H组中CRP、FIB、C3、ScrI、L-6和Ccr均显著高于L组,差异具有统计学意义(P<0.05),而Fe在两组间差异无统计学意义(P>0.05)。相关分析表明,CPR、FIBI、L-6均分别与ICI、Scr和Ccr呈正相关关系(P<0.05);Fe与ICI呈正相关(P<0.05),而与Scr和Ccr无明显相关关系(P>0.05)。结论 PNS患者体内急性期蛋白CRP、FIB和IL-6水平,可做为反映肾小球内凝血状态和肾小球滤过率变化的参考指标之一。
Objective To investigate the relationship between acute nephropathy protein and Itraglomerular coagulation index (CI) and renal function in patients with primary nephrotic syndrome (PNS), so as to provide new information for the prevention and treatment of PNS renal failure Strategy. Methods Fifty-six patients with PNS admitted to our hospital from January 2007 to December 2009 were enrolled. All patients were enrolled in this study. According to the ICI level I, CI <0.5 for the L group (26 cases) I, CI> 1.0 for the H group (30 cases). The urine urinary proteinuria (Upro) and urinary micro-protein degradation products (FDP) were measured for ICI (ICI = Upro / FDP); the levels of C-reactive protein (CRP), fibrinogen (FIB) , Creatinine (Scr), ferritin (Fe) and interleukin-6 (IL-6) were measured. The creatinine clearance rate (Ccr) was calculated according to the Cockcroft-Gault formula. Related indicators for pearson analysis. Results The levels of CRP, FIB, C3, ScrI, L-6 and Ccr in group H were significantly higher than those in group L (P <0.05), but there was no significant difference in Fe between the two groups (P> 0.05 ). Correlation analysis showed that CPR, FIBI and L-6 were positively correlated with ICI, Scr and Ccr (P <0.05), Fe was positively correlated with ICI (P <0.05), but not with Scr and Ccr > 0.05). Conclusion The levels of CRP, FIB and IL-6 in acute phase of PNS patients can be used as a reference index to reflect the changes of glomerular coagulation status and glomerular filtration rate.