The research relationship between urinary podocalyxin, nephrin and urinary protein in children with primary nephrotic syndrome

doi:10.3877/cma.j.issn.1673-5250.2015.04.016

Objective

To identify the relationships between proteinuria and foot process damage of primary nephrotic syndrome(NS).

Methods

From September 2013 to March 2014, a total of 20 patients with primary NS were selected as the research group(n=20) in Harbin Children's Hospital.Meanwhile 10 healthy children were selected as normal control group(n=10). The children in research group were treated with adrenal cortex hormone therapy.The levels of podocalyxin (PCX) and nephrin at different observation time in the nephropathy group and at random interval in normal control group were detected by enzyme-linked immunosorbent assay (ELISA) method.The serum levels of urine protein and urine creatinine were measured by the method of turbidimetric inhibition immuno assay and colorimetry.

Results

①The levels of urinary PCX, nephrin and urine protein/creatinine in research group were significantly higher than those of the normal control group(t=2.612, 2.843, 2.972; P<0.01). ②PCX, nephrin and urine protein/urine creatinine levels were decreased during the treatment in research group. There was no significant difference in urine PCX and nephrin between every couple of adjacent observation time (P>0.05). The levels of urinary PCX and nephrin were significantly decreased between the eighth day and before treatment, and the differences were statistically significant(t=1.934, 2.093; P<0.05). The levels of urinary protein/urine creatinine were significantly decreased between the sixth day and the forth day or before treatment, and the differences were also statistically significant(t=2.042, 2.120; P<0.05). ③PCX and nephrin levels were positively correlated with urine protein/urine creatinine levels (r=0.91, 0.92; P<0.01).

Conclusions

The levels of PCX and nephrin decreased with the recovery of NS, and it had a good correlation with urinary protein index, carrying on a quantitative detection of dynamic observation podocyte changes.It has certain clinical significance for judging the glomerular damage and recovery.

Key words: Nephritic, Proteinuria, Podocyte, Podocalyxin, Nephrin

表1 两组儿童尿PCX、nephrin水平及尿蛋白、尿肌酐比值比较(±s)

组别	例数	PCX(ng/mL)	Nephrin(ng/mL)	尿蛋白/尿肌酐
肾病组	20	9.34±2.14	8.99±0.62	7.47±2.82
正常对照组	10	3.89±0.44	2.53±0.46	0.21±0.18
t值		2.612	2.843	2.972
P值		<0.01	<0.01	<0.01

表1 两组儿童尿PCX、nephrin水平及尿蛋白、尿肌酐比值比较(±s)

组别	例数	PCX(ng/mL)	Nephrin(ng/mL)	尿蛋白/尿肌酐
肾病组	20	9.34±2.14	8.99±0.62	7.47±2.82
正常对照组	10	3.89±0.44	2.53±0.46	0.21±0.18
t值		2.612	2.843	2.972
P值		<0.01	<0.01	<0.01

表2 儿童肾病恢复期尿PCX、nephrin水平及尿蛋白、尿肌酐比值比较(±s)

观察指标(尿液)	观察时间点
观察指标(尿液)	治疗前	第2天	第4天	第6天	第8天
PCX(ng/mL)^a	9.34±2.14	9.31±2.23	9.02±2.29	8.35±2.60	6.87±2.27^b
Nephrin(ng/mL)^a	8.99±0.62	8.79±0.73	8.53±0.97	7.93±0.86	6.52±1.41^b
尿蛋白/尿肌酐比值	7.47±2.82	6.90±3.12	5.03±2.98	2.83±1.20^c	1.55±0.79

表2 儿童肾病恢复期尿PCX、nephrin水平及尿蛋白、尿肌酐比值比较(±s)

观察指标(尿液)	观察时间点
观察指标(尿液)	治疗前	第2天	第4天	第6天	第8天
PCX(ng/mL)^a	9.34±2.14	9.31±2.23	9.02±2.29	8.35±2.60	6.87±2.27^b
Nephrin(ng/mL)^a	8.99±0.62	8.79±0.73	8.53±0.97	7.93±0.86	6.52±1.41^b
尿蛋白/尿肌酐比值	7.47±2.82	6.90±3.12	5.03±2.98	2.83±1.20^c	1.55±0.79

图1 儿童肾病不同观察时刻尿PCX、nephrin水平和尿蛋白/尿肌酐比值比较

图2 尿PCX与尿蛋白/尿肌酐直线相关分析

图3 尿nephrin与尿蛋白/尿肌酐直线相关分析

[1]	中华医学会儿科学分会肾脏病学组．小儿肾小球疾病的临床分类、诊断及治疗[J]．中华儿科杂志，2001；39(12)：746–749.
[2]	Asao R, Asanuma K, Kodama F，et al. Relationships between levels of urinary podocalyxin，number of urinary podocalyxin，number of urinary podocytes，and histologic injury in adult patients with IgA nephropathy[J]．Clin J Am Soc Nephrol，2012，7(9)：1385–1393.
[3]	Zhu B，Li XF，Zhu XL，et al. ELISA analysis of urinary nephrin and podocalyxin standardized by aquaporin-2 in adult patients with nephritic syndrome[J]．J Nephrol，2014，27(4)：411–417.
[4]	Mundel P，Shankland SJ.Podocyte biology and response to injury[J]．J Am Soc Nephrol，2002，13(12)：3005–3015.
[5]	邢燕，叶山东．Podocalyxin与糖尿病肾病的关系[J]．国际病理科学与临床杂志，2011，31(2)：172–174.
[6]	Kanno K，Kawachi H，Uchida Y，et al.Urinary sediment podocalyxin in children with glomerular disease[J]．Nephron Clin Pract，2003，95(3)：91–99.
[7]	Habara P，Mareckova H，Malickova K，et al.Novel flow cytometric method for the detection of podocalyxin-positive elements in urine of pations with glomerulinephritide-first promising results[J]．Folia Biol(Praha)，2012，58(2)：57–63.
[8]	邢燕，丁洁，范青锋．足细胞分子高表达致阿霉素肾病大鼠发生蛋白尿[J]．中华肾脏病杂志，2006，22(1)：281–285.
[9]	邓江红，丁洁．从足细胞相关分子的研究认识足突融合现象[J]．肾脏病与透析移植，2005，4(14)：354–356.
[10]	张焱，黄建萍，肖慧捷，等．甲基泼尼松龙冲击疗法治疗小儿肾病综合征复发疗效观察[J]．临床儿科杂志，2007，25(4)：274–277.
[11]	刘涛，张碧丽，李莉．检测原发性肾病综合征患儿尿足细胞标志蛋白的临床意义[J]．中国当代儿科杂志，2012，14(5)：332–335.
[12]	刘海梅，徐虹，高霞．地塞米松影响足细胞活动力的相关分子研究[J]．中华肾脏病杂志，2012，9(28)：705–709.
[13]	赵向娅，冯晓蓓，王朝晖．尿足细胞及其相关分子在肾小球疾病中的表达[J]. 中国中西医结合肾病杂志，2009，6(6)：489–493.
[14]	鲁艳芳，袁军．足细胞相关分子与蛋白尿的关系[J]．中国中西医结合儿科学，2009，1(1)：74–77.
[15]	张爱华．肾小球足细胞裂孔隔膜分子在蛋白尿发生中的作用[J]．医学研究生学报，2009，7(22)：673–676.

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