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目的低蛋白血症是肾病综合征(nephrotic syndrome,NS)患者的典型特征之一,其原因可能与大量蛋白随尿液丢失有关。而低胆红素血症亦为NS患者常见临床症状。为揭示二者间的关系,该研究对NS、慢性肾小球肾炎(chronic glomerulonephritis,CGN)及术后胃瘫综合征(postoperative gastroparesis syndrome,PGS),白蛋白(albumin,ALB)<35 g/L患者的胆红素、ALB及24 h尿蛋白定量进行了对比研究。方法选取NS 187例、原发性CGN 70例、PGS(ALB<35 g/L)64例,检测ALB、尿蛋白(urinary protein,UPR)、尿微量白蛋白/肌酐(urinary microalbuminuria/creatinine,Umalb/cr)及总胆红素(TBIL),应用SPSS 17.0软件分析组间差异及TBIL与UPR、ALB的相关性。结果NS组、CGN组及PGS组人群TBIL、ALB、UPR及Umalb/Cr水平存在显著差异(one-way ANOVA test,P<0.05),且NS组和CGN组TBIL与ALB均呈正相关,TBIL与UPR及Umalb/Cr均呈负相关(Spearman’s rho test,P<0.05);但PGS组上述观察指标间未见相关性(Spearman’s rho test,P>0.05)。结论 NS患者血胆红素低水平与血ALB水平呈正相关,与尿蛋白、微量ALB水平呈负相关;且PGS及CGN患者对照比较,PGN患者血胆红素与血ALB没有关联性。结果表明,NS患者低血胆红素的原因可能为部分胆红素随尿蛋白的排出而丢失所致。
Aim Hypoalbuminemia is one of the typical features of patients with nephrotic syndrome (NS), which may be related to the loss of a large number of proteins with the urine. Low bilirubin is also common clinical symptoms of NS patients. To reveal the relationship between NS, chronic glomerulonephritis (CGN) and postoperative gastroparesis syndrome (PGS), albumin (ALB) <35 g / L patients with bilirubin, ALB and 24 h urinary protein were compared. Methods 187 cases of NS, 70 cases of primary CGN and 64 cases of PGS (ALB <35 g / L) were selected for detection of urinary proteinuria (UPR), urinary microalbuminuria / creatinine (Umalb / cr) and total bilirubin (TBIL). SPSS 17.0 software was used to analyze the differences between groups and the correlation between TBIL and UPR and ALB. Results The levels of TBIL, ALB, UPR and Umalb / Cr in NS, CGN and PGS groups were significantly different (one-way ANOVA test, P <0.05). TBIL and ALB in NS and CGN groups were positively correlated UPR and Umalb / Cr showed negative correlation (Spearman’s rho test, P <0.05). However, there was no correlation between the above indexes in the PGS group (Spearman’s rho test, P> 0.05). Conclusions The serum bilirubin levels in NS patients are positively correlated with the level of blood ALB, and negatively correlated with urinary albumin and ALB levels. There is no correlation between serum bilirubin and blood ALB in patients with PGN and CGN. The results show that NS patients with low serum bilirubin may be the reason for the loss of some bilirubin with the urinary protein excretion.