成人肾病综合征患者黄斑区视网膜厚度与尿蛋白的相关性研究

doi:10.11958/20221421

天津医药 ›› 2023, Vol. 51 ›› Issue (8): 869-872.doi: 10.11958/20221421

成人肾病综合征患者黄斑区视网膜厚度与尿蛋白的相关性研究

郭玉峰¹(), 刘玉梅¹, 毕秀增¹, 郭俊麟¹, 孙莉¹, 王维秀², 杨定位²

1 天津市天津医院眼科（邮编300211）
2 天津市天津医院肾内科（邮编300211）

收稿日期:2022-09-14 修回日期:2023-02-06 出版日期:2023-08-15 发布日期:2023-08-10
作者简介:郭玉峰（1972），女，副主任医师，主要从事眼与全身疾病方面研究。E-mail：pll9651@126.com
基金资助:
天津市卫生健康科技项目(ZC20027);天津市卫生健康委员会重点项目(TJWJ2021ZD005)

Correlation between macular retinal thickness and urinary protein in adult patients with nephrotic syndrome

GUO Yufeng¹(), LIU Yumei¹, BI Xiuzeng¹, GUO Junlin¹, SUN Li¹, WANG Weixiu², YANG Dingwei²

1 Department of Ophthalmology, Tianjin Hospital, Tianjin 300211, China
2 Department of Nephrology, Tianjin Hospital, Tianjin 300211, China

Received:2022-09-14 Revised:2023-02-06 Published:2023-08-15 Online:2023-08-10

郭玉峰, 刘玉梅, 毕秀增, 郭俊麟, 孙莉, 王维秀, 杨定位. 成人肾病综合征患者黄斑区视网膜厚度与尿蛋白的相关性研究[J]. 天津医药, 2023, 51(8): 869-872.

GUO Yufeng, LIU Yumei, BI Xiuzeng, GUO Junlin, SUN Li, WANG Weixiu, YANG Dingwei. Correlation between macular retinal thickness and urinary protein in adult patients with nephrotic syndrome[J]. Tianjin Medical Journal, 2023, 51(8): 869-872.

摘要/Abstract

摘要：

目的探讨成人肾病综合征患者黄斑区视网膜厚度与尿蛋白的相关性。方法选择内科收治的住院患者112例，按照尿蛋白检测结果分为正常尿蛋白组28例（56眼）、轻度异常尿蛋白组30例（58眼）、中度异常尿蛋白组27例（51眼）、肾病综合征组27例（53眼）。利用光学相干断层扫描仪（OCT）测量黄斑中央区（Center）、内环颞侧（InT）、内环上方（InS）、内环鼻侧（InN）、内环下方（InI）、外环颞侧（OutT）、外环上方（OutS）、外环下方（OutI）、外环鼻侧（OutN）9个区域视网膜平均厚度，采用相关比率E²对各组黄斑区视网膜平均厚度与尿蛋白分级进行相关性分析。结果轻度异常尿蛋白组黄斑区Center、InT、InN和InI视网膜平均厚度高于正常尿蛋白组，中度异常尿蛋白组黄斑区Center、InT、InS、InN、InI和OutN视网膜平均厚度低于轻度异常尿蛋白组，肾病综合征组黄斑区InT、InS、InN和InI视网膜平均厚度高于中度异常尿蛋白组（均P<0.05）。黄斑区InT、InS、InN、InI视网膜平均厚度与尿蛋白严重程度呈中度相关（0.06≤E²<0.16），Center、OutN视网膜平均厚度与尿蛋白严重程度的相关性较弱（E²<0.06）。结论黄斑区InT、InS、InN、InI视网膜平均厚度有可能成为成人肾病综合征早期病变的生物标志物。

关键词: 肾病综合征, 体层摄影术, 光学相干, 尿蛋白, 黄斑区视网膜厚度

Abstract:

Objective To investigate the correlation between retinal thickness in macular area and urinary protein in adult patients with nephrotic syndrome. Methods A total of 112 inpatients admitted to the internal medicine department were selected and divided into the normal urine protein group (28 cases, 56 eyes), the mildly abnormal urine protein group (30 cases, 58 eyes), the moderately abnormal urine protein group (27 cases, 51 eyes) and the nephrotic syndrome group (27 cases, 53 eyes) according to results of urine protein detection. Optical coherence tomography (OCT) was used to measure the average retinal thickness of the nine divisions in the macula regions, including the central region (Center), temporal side of the inner ring (InT), superior the inner ring (InS), nasal side of the inner ring (InN), inferior the inner ring (InI), temporal side of the outer ring (OutT), superior the outer ring (OutS), inferior the outer ring (OutI) and nasal side of the outer ring (OutN). The correlation ratio E² was used to analyze the correlation between the mean retinal thickness of different macular regions and the grading of urinary protein in each group. Results The mean retinal thickness of Center, InT, InN and InI in the macular area was higher in the mildly abnormal urine protein group than that in the normal urine protein group. The mean retinal thickness of Center, InT, InS, InN, InI and OutN in the macular area was lower in the moderately abnormal urine protein group than that in the mildly abnormal urine protein group, and the mean retinal thickness of InT, InS, InN and InI in the macular area was higher in the nephrotic syndrome group than that in the moderately abnormal urinary protein group (All P<0.05). The mean retinal thickness of InT, InS, InN and InI in macular area was moderately correlated with the severity of urinary protein group (0.06≤E²<0.16), while the mean retinal thickness of Center and OutN in macular area was weakly correlated with the severity of urinary protein group (E²<0.06). Conclusion The mean retinal thickness of InT, InS, InN and InI in macular area may be biomarkers of early lesions of adult nephrotic syndrome.

Key words: nephrotic syndrome, tomography, optical coherence, urine protein, macular retinal thickness

中图分类号:

R771.3

图/表 4

参考文献 21

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组别	n	男性/例（%）	眼别（右/左）/例	年龄/岁
A组	28	22（78.6）	28/28	67.36±6.00
B组	30	23（76.7）	30/28	67.90±8.30
C组	27	22（81.5）	27/24	68.15±8.07
D组	27	20（74.1）	27/26	65.93±7.09
χ²或F		0.458	0.099	0.489

组别	n	男性/例（%）	眼别（右/左）/例	年龄/岁
A组	28	22（78.6）	28/28	67.36±6.00
B组	30	23（76.7）	30/28	67.90±8.30
C组	27	22（81.5）	27/24	68.15±8.07
D组	27	20（74.1）	27/26	65.93±7.09
χ²或F		0.458	0.099	0.489

组别	n		Center			InT			InS
A组	56		223.02±17.05			280.09±17.09			292.93±16.34
B组	58		240.03±23.56^a			291.02±21.98^a			301.29±19.49
C组	51		227.00±30.21^b			275.53±31.49^b			285.04±23.33^b
D组	53		235.38±40.30^a			291.66±35.43^ac			298.75±30.71^c
F			4.047^＊			4.664^＊			5.276^＊
组别		InN			InI			OutT
A组		292.79±17.85			285.95±19.77			250.41±14.27
B组		304.24±18.73^a			298.57±22.20^a			252.47±19.71
C组		286.94±28.18^b			280.53±30.86^b			245.41±25.32
D组		300.09±28.12^c			293.91±33.98^c			250.11±33.81
F		5.775^＊			4.792^＊			0.811
组别		OutS		OutI			OutN
A组		261.95±15.65		276.95±16.16			255.84±13.46
B组		263.95±17.93		280.31±20.72			258.33±18.30
C组		256.90±19.82		271.51±22.52			245.29±19.36^ab
D组		263.19±29.54		279.79±28.52			251.15±33.58
F		1.169		1.722			3.555^＊

组别	n		Center			InT			InS
A组	56		223.02±17.05			280.09±17.09			292.93±16.34
B组	58		240.03±23.56^a			291.02±21.98^a			301.29±19.49
C组	51		227.00±30.21^b			275.53±31.49^b			285.04±23.33^b
D组	53		235.38±40.30^a			291.66±35.43^ac			298.75±30.71^c
F			4.047^＊			4.664^＊			5.276^＊
组别		InN			InI			OutT
A组		292.79±17.85			285.95±19.77			250.41±14.27
B组		304.24±18.73^a			298.57±22.20^a			252.47±19.71
C组		286.94±28.18^b			280.53±30.86^b			245.41±25.32
D组		300.09±28.12^c			293.91±33.98^c			250.11±33.81
F		5.775^＊			4.792^＊			0.811
组别		OutS		OutI			OutN
A组		261.95±15.65		276.95±16.16			255.84±13.46
B组		263.95±17.93		280.31±20.72			258.33±18.30
C组		256.90±19.82		271.51±22.52			245.29±19.36^ab
D组		263.19±29.54		279.79±28.52			251.15±33.58
F		1.169		1.722			3.555^＊

指标	Center× 分组	InT× 分组	InS× 分组	InN× 分组	InI× 分组	OutN× 分组
Eta	0.232	0.248	0.262	0.274	0.251	0.218
E²	0.054^＊	0.061^＊＊	0.069^＊＊	0.075^＊＊	0.063^＊＊	0.047^＊

成人肾病综合征患者黄斑区视网膜厚度与尿蛋白的相关性研究

Correlation between macular retinal thickness and urinary protein in adult patients with nephrotic syndrome

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