【摘要】 目的 前瞻性观察儿科肾小球疾病的肾小管功能改变。方法 对64例有各种肾小球疾病但肾功能正常者(A组)，29例急性肾功能不全者(B组)及73例对照者(C组)3组患儿肾小管功能进行前瞻性观察。将尿β2-微球蛋白(β2-MG)及尿溶菌酶(LYS)作为近端肾小管功能、24h尿Tamm-Horsfall蛋白(THP)作为远端肾小管功能的评估指标，并与血尿素氮(BUN)、血肌酐(BCr)(肾小球功能)相对照。结果 BUN、BCr及尿β2-MG、LYS、THP在A，C两组间差异无显著性，而在B与A、C组间差异均有显著性。在B组中，血BUN、BCr分别与β2-MG、LYS、THP均无显著相关性。结论 小儿肾小球疾病肾小球功能在正常范围时，肾小管功能无明显改善；一旦肾小球功能受损伤时，则肾小管功能即有不同程度受损，且两者受损程度平行。

    【关键词】 肾小管功能；肾小球疾病；小儿

    Detection of tubular function of children glomerular disease

    SONG Chao-zheng，SHI Yu,FU Jun-fang,et al.

    Department of Pediatrics, Yichang Central People’s Hospital, Yichang 443003,China

    【Abstract】 Objective To detect the tubular function of children glomerular disease.Methods All cases were divided into three groups. Group A:64 cases with various glomerular disease (on acute stages )whose tubular function were normal, of which 24 cases of acute poststreptoccocal glomerulonephritis, 18 cases of nephrotic syndrome, 7 cases of isolated hematuria, 4 cases of isolated proteinuria, 9 cases of Henoch-Schonlein nephritis, 2 cases of other secondary glomerular disease. Group B:29 cases of acute glomerular disease on oliguria stage had renal insufficiency. Manifestions of tubular injury in group A and B, such as polyphagia,polyuria and positive urine sugar etc, were not typical, renal biopsy didn’t show any pathological change in renal tubules and tubulointerstitium. Group C:73 cases of respiratory disease on convalescence stage who were admitted at the same time. Both sex and age could be compared among three groups. The urine beta-2 microglobulin(β2-MG) of 24 hours and Lysozyme(Lys) were served as indexes for assessing proximal tubular function, the Tamm-Horsfall protein(THP) of 24 hours urine was served as indexes for assessing distal tubular function. The blood BUN and BCr were served as indexes for assessing glomerule function. Results The blood BUN (mmol/L) and BCr (μmol/L)of the three groups were 7.11±1.17 ......