摘要
目的探讨核素肾动态显像单光子发射计算机断层扫描仪(ECT)检查与肾盂尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、凋亡DNA片段(ADF)水平检测在评定肾积水患儿病肾损害中的临床价值。方法采用核素肾动态显像ECT检查测定41例肾积水患儿肾小球滤过率(GFR),酶联免疫吸附法(ELISA)检测病肾尿NAG、ADF水平,并以其中21例健侧肾尿NAG、ADF作对照。41例患儿行病肾组织学检查分级(按Elder等标准分为Ⅰ～Ⅴ级),并以病理分级为标准对病肾GFR和尿NAG、ADF进行分组,行组内统计学处理,再将病理分级与病肾GFR、尿NAG及尿ADF水平行相关分析。结果1.病肾GFR明显降低[(143.86±17.51)×10-3L/min],与健侧肾GFR值[(174.33±20.43)×10-3L/min]比较差异有统计学意义(P<0.01)。2.病肾及健侧肾尿NAG分别为(5.91±0.17)×10-3IU/L、(3.31±0.11)×103IU/L,二者比较差异有统计学意义(P<0.05);病肾及健侧肾尿ADF分别为(0.56±0.15)、(0.51±0.13),二者比较差异无统计学意义(P>0.05)。3.病肾GFR与病理分级呈显著负相关(r=-0.814P<0.01);病肾尿NAG与病理分级呈正相关(r=0.769P<0.05),病肾尿ADF与病理分级无相关性(P>0.05)。结论肾积水患儿病肾尿NAG检测可早期反映病肾小管的损害,病肾GFR降低表明肾损害已累及肾小球,尿ADF水平检测不能反映病肾损害。
Objective To explore the clinical value of renal dynamic imaging and urinary N - acetyl - β -D - glucosaminidase （ NAG）, apoptosis DNA fragment（ADF） in evaluating the damage degree of hydronephrotic kidneys（HnK） in children with hydronephrosis. Methods Level of glomerular filtration rate（GFR） was detected in 41 children with congenital hydronephmsis by renal dynamic imaging, and urine NAG, ADF in pelvis in HnK and healthy kidneys （as controls） were detected by enzyme -linked immuno -sorbent assay（ ELISA）. Pathologic changes of HnK in 41 children were graded into Ⅰ -Ⅴ according to Eider standard. And GFR,urinary NAG and ADF of HnK were divided into subgroup according to pathologic changes ,at the same time statistical analysis was performed within each groups. And the correla tions of pathologic grades with GFR,urinary NAG and ADF of HnK were analyzed. Results 1. Kindneys GFR in healthy kidneys and Hnk were （174.33 ±20.43 ） ×10-3 L/min, （143.86 ± 17.51 ） × 10-3 L/rain respectinely, and there was significant difference between healthy kidneys and Hnk （P 〈 0.01 ）. 2. Urine NAG in healthy kidneys and Hnk were（3.31 ± 0.11 ） × 10^-3 IU/L, （5.91 ± 0.17） × 10^3 IU/L （P 〈 0.05 ） ; and ADF in healthy kidneys and Hnk were （ 0.51±0. 13 ）, （ 0.56 ± 0.15 ）, and there was no significant difference （ P 〉 0.05 ）. 3. There was significant negative correlation between GFR levels of HnK and pathologic grades （ r = - 0. 814 P 〈 0. 01 ） ; whereas, there was positive correlation between urine NAG of HnK and pathologic grades with significance （ r = 0. 769 P 〈 0.05 ） , but urine ADF of HnK had no correlation with pathologic grades （ P 〉 0.05 ）. Conclusions For hydronephrotic kidneys, urinary NAG can eva-luate impaired nephric tubule whereas renal dynamic imaging may evaluate the damage level of glomeruli ; urine ADF may not indicate the damage level of diseased kidneys in children with congenital hvdronephrosis.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2009年第16期1282-1284,1288,共4页
Journal of Applied Clinical Pediatrics
基金
贵州省优秀科技教育人才省长专项资金项目(黔省专合字2006-45号)
合肥医学院博士启动资金(F-207)
