炎症性肠病患者的微量蛋白尿：它与疾病活动度还是5-氨基水杨酸治疗有关？
Microproteinuria in patients with inflammatory bowel disease: is it associated with the disease activity or the treatment with 5-aminosalicylic acid?
作者信息
Poulou Androniki C, Goumas Konstantinos E, Dandakis Dimitrios C, Tyrmpas Ioannis, Panagiotaki Maria, Georgouli Androniki, Soutos Dimitrios C, Archimandritis Athanasios
机构信息
Gastroenterology Department, Red Cross Hospital of Athens, Greece.
出版信息
World J Gastroenterol. 2006 Feb 7;12(5):739-46. doi: 10.3748/wjg.v12.i5.739.
AIM
To investigate whether microproteinuria in patients with inflammatory bowel disease (IBD) is associated with the disease activity or the treatment with 5-aminosalicylic acid (5-ASA).
METHODS
We prospectively studied microproteinuria in 86 consecutive patients with IBD, 61 with ulcerative colitis (UC) and 25 with Crohn's disease (CD), before as well as 2 and 6 months after their inclusion in the study. Forty-six patients received 5-ASA for a period of 28.8 months (range 1-168 mo). Microalbuminuria (mALB) and urine levels of the renal tubular proteins beta2-microglobulin (beta2mGLB) and beta-N-acetyl-D-glucosamidase (beta-NAG) as well as the creatinine clearance were determined in a 12-h overnight urine collection. Tumor necrosis factor-alpha (TNF-alpha) serum levels were also measured.
RESULTS
A total of 277 measurements (194 in UC patients and 83 in CD patients) were performed. The prevalence of abnormal microproteinuria in UC and CD patients was 12.9% and 6.0% for mALB, 22.7% and 27.7% for beta2mGLB, and 11.3% and 8.4% for beta-NAG, respectively. mALB was not associated with IBD activity. Beta2mGLB and beta-NAG urine levels were correlated to UC activity (UCAI: P<0.01; UCEI: P<0.005). mALB in UC patients and beta-NAG urine levels in CD patients were related to TNF-alpha serum levels. An association was noticed between microproteinuria and smoking habit. Treatment with 5-ASA was not correlated to the severity of microproteinuria or to the changes of creatinine clearance.
CONCLUSION
Microproteinuria is mainly associated with UC and its activity but not affected by 5-ASA.
目的
研究炎症性肠病（IBD）患者的微量蛋白尿是否与疾病活动度或5-氨基水杨酸（5-ASA）治疗有关。
方法
我们对86例连续性IBD患者进行了前瞻性研究，其中61例为溃疡性结肠炎（UC）患者，25例为克罗恩病（CD）患者，在纳入研究前以及纳入研究后2个月和6个月时进行观察。46例患者接受了为期28.8个月（范围1 - 168个月）的5-ASA治疗。通过收集12小时夜间尿液来测定微量白蛋白尿（mALB）、肾小管蛋白β2-微球蛋白（β2mGLB）和β-N-乙酰-D-葡萄糖苷酶（β-NAG）的尿水平以及肌酐清除率。还测定了血清肿瘤坏死因子-α（TNF-α）水平。
结果
共进行了277次测量（UC患者194次，CD患者83次）。UC和CD患者中，mALB异常微量蛋白尿的患病率分别为12.9%和6.0%，β2mGLB分别为22.7%和27.7%，β-NAG分别为11.3%和8.4%。mALB与IBD活动度无关。β2mGLB和β-NAG尿水平与UC活动度相关（UCAI：P<0.01；UCEI：P<0.005）。UC患者的mALB和CD患者的β-NAG尿水平与TNF-α血清水平相关。注意到微量蛋白尿与吸烟习惯之间存在关联。5-ASA治疗与微量蛋白尿的严重程度或肌酐清除率的变化无关。
结论
微量蛋白尿主要与UC及其活动度相关，但不受5-ASA影响。
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