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目的探讨梗阻性肾病患者血清中Ⅲ型前胶原(PCⅢ)及Ⅲ型前胶原氨基末端肽(PⅢNP)浓度的变化与肾功能受损程度及可复性的关系。方法收集本院泌尿外科单侧肾积水患者30例,分为3组,轻度肾积水组、中度肾积水组、重度肾积水组各10例,另外取10例健康者作为对照组;采用放射免疫法测定各组血清中PCⅢ及PⅢNP的含量;用99mTc-DTPA肾动态显像法测定各积水组治疗前后的肾小球滤过率(GFR);对血清中PCⅢ及PⅢNP含量与治疗前后GFR进行相关性研究。结果①3组肾积水患者血清中PCⅢ及PⅢNP值整体上较对照组均升高,且随积水程度加重血清中PCⅢ及PⅢNP值逐渐升高,各积水组与对照组、以及各积水组两两间比较差异有统计学意义(P<0.05);②肾积水患者血清PCⅢ及PⅢNP浓度与术前患侧GFR呈负相关(r=-0.819,P<0.01);③轻度及中度积水组治疗后患侧GFR明显升高(P<0.05),重度积水组治疗后患侧GFR升高不明显(P>0.05)。结论肾积水患者血清中PCⅢ及PⅢNP值随积水程度加重逐渐升高;肾积水血清中PCⅢ及PⅢNP值与患侧GFR呈负相关;推测在排除肾外脏器纤维化的前提下,血清PCⅢ及PⅢNP对评价肾积水肾功能变化具有一定指导意义。
Objective To investigate the relationship between the changes of serum levels of type Ⅲ procollagen (Ⅲ) and type Ⅲ procollagen aminopeptidase (P Ⅲ NP) in patients with obstructive nephropathy and the degree of renal dysfunction and refolding. Methods Thirty patients with unilateral hydronephrosis in our department were divided into three groups: mild hydronephrosis group, moderate hydronephrosis group and severe hydronephrosis group, and 10 healthy individuals The levels of PCⅢ and PⅢNP in serum of each group were measured by radioimmunoassay. GFR was measured before and after treatment with 99mTc-DTPA renal dynamic imaging. PⅢNP content and GFR before and after the study. Results ① The levels of PCⅢ and PⅢNP in serum of patients with hydronephrosis in group 3 were higher than those in control group as a whole, and the levels of PCⅢ and PⅢNP in serum were increased gradually with the severity of hydrocephalus. In each group of hydronephrosis and control group, (P <0.05); ② The serum levels of PCⅢ and PⅢNP were negatively correlated with preoperative GFR (r = -0.819, P <0.01); ③ mild and moderate GFR was significantly increased in the moderate hydronephrosis group (P <0.05), and GFR in the severe hydronephrosis group was not significantly increased after treatment (P> 0.05). Conclusions The serum levels of PCⅢ and PⅢNP in patients with hydronephrosis gradually increase with the degree of hydrops. The values of PCⅢ and PⅢNP in serum of hydronephrosis are negatively correlated with the GFR of the affected side. Presuming that the exclusion of extranodal fibrosis, Serum PCⅢ and PⅢNP have some guiding significance in evaluating renal function changes of hydronephrosis.