ter Borg E J, de Jong P E, Meijer S S, Kallenberg C G
Department of Internal Medicine, University Hospital Groningen, The Netherlands.
Am J Nephrol. 1991;11(1):16-22. doi: 10.1159/000168266.
We prospectively studied renal tubular function during 11 consecutive exacerbations of proliferative glomerulonephritis in 8 patients with systemic lupus erythematosus (SLE). We found a rise in the fractional excretion of beta 2-microglobulin (p less than or equal to 0.05) and dimercaptosuccinic acid (DMSA; p less than or equal to 0.02) during the exacerbations. These changes coincided with a fall in the glomerular filtration rate (p less than or equal to 0.02). Since fractional excretion of beta 2-microglobulin and DMSA can be considered as markers for tubular function, their rise during exacerbation and their fall (p less than or equal to 0.01) to control values during remission indicate that tubular dysfunction frequently occurs during active proliferative glomerulonephritis in SLE and can be influenced by immunosuppressive treatment. As no correlation was found between the different tubular function studies and the activity index of tubulointerstitial abnormalities in the renal biopsy, it is suggested that tubular function studies are probably a more sensitive indicator of tubulointerstitial disease than this activity index.
我们对8例系统性红斑狼疮（SLE）患者的11次增殖性肾小球肾炎连续加重期的肾小管功能进行了前瞻性研究。我们发现，在加重期，β2-微球蛋白的分数排泄率升高（p≤0.05），二巯基丁二酸（DMSA）的分数排泄率升高（p≤0.02）。这些变化与肾小球滤过率下降同时出现（p≤0.02）。由于β2-微球蛋白和DMSA的分数排泄率可被视为肾小管功能的标志物，它们在加重期升高，而在缓解期降至对照值（p≤0.01），这表明在SLE患者的活动性增殖性肾小球肾炎期间，肾小管功能障碍经常发生，并且可受免疫抑制治疗的影响。由于在不同的肾小管功能研究与肾活检中肾小管间质异常的活动指数之间未发现相关性，因此提示肾小管功能研究可能是比该活动指数更敏感的肾小管间质疾病指标。
