关键词: 重度肾积水, 经皮肾穿刺造瘘术/肾造口术, 肾功能, 尿蛋白

Abstract: Objective To investigate the changes and clinical significance of microalbumin(mAlb),transferrin(TRF),immunoglobulin G(IgG),α1-MG and β2-MG in the drainage fluid of renal pelvis after percutaneous nephrostomy(PCN) for adult severe hydronephrosis.Methods The clinical data of 33 adults with unilateral severe hydronephrosis before and after PCN with glomerular filtration rate(GFR) ≤ 10ml / min were analyzed retrospectively.Including the biochemical indexes of renal GFR,PCN and drainage fluid before and 1 month after operation.Based on the recovery of GFR in the affected kidney one month after operation,33 subjects were divided into improved renal function group(n=18) and non improved renal function group(n=15).The contents of mAlb,TRF,IgG,α1-MG and β2-MG in drainage fluid between the two groups were analyzed whether there were differences during and after operation,and whether there was correlation with GFR in the affected kidney.Results One month after PCN,the contents of mAlb,TRF,IgG,α1-MG and β2-MG in the renal function improvement group were lower than those during operation(P＜0.05),and the postoperative GFR was higher than that before operation(P＜0.05).There were significant differences in intraoperative α1-MG,β2-MG and preoperative and postoperative GFR between the two groups(P＜0.05).There was a negative correlation between α1-MG,β2-MG,mAlb,IgG,TRF and GFR in the drainage fluid of renal pelvis retained by PCN.The r values were -0.86、-0.83、-0.75、-0.79、-0.72，respectively.Conclusion Severe hydronephrosis leads to the recovery of renal function in varying degrees after the damaged kidney is drained through PCN.PCN can improve the glomerular filtration function of adults with severe hydronephrosis and restore the reabsorption function of renal tubules to a certain extent.The contents of mAlb,TRF,IgG,α1-MG andβ2-MG in the drainage fluid of renal pelvis have a good correlation with the GFR measured by ect.Among them,α1-MG andβ2-MG can be used as sensitive indexes to evaluate the recovery of renal tubular function.The patient measured the protein content through PCN and retained the renal pelvis drainage fluid,evaluated the improvement of renal function,reduced unnecessary imaging examinations,and saved medical expenses.

Key words: severe hydronephrosis, percutaneous nephrostomy/nephrostomy, renal function, urinary protein