특발성신중후군 환자의 혈청 및 요단백 전기영동분획상에 관한 연구 = A Study of Serum and Urine Protein Eleytrophoresis in Patients with Idiopathic Nephorotic Syndrome

다국어 초록 (Multilingual Abstract)

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다국어 초록 (Multilingual Abstract)

Background: The idiopathic nephrotic syndrome is classified into minimal change nephrotic syndrome, focal glomerulosclerosis, membranous glomerulonephritis and membranoproliferative glomerulonephritis. They have different histological features and different capillary wall permeability to serum protein. The difference of capillary wall permeability to serum protein may leads to changes of serum and urinary protein composition. But there has been no report about that. Thereby we had carried out the electrophoresis of the serum and urinary protein obtained from the patient with idiopathic nephrotic syndrome. Methods: To investigate the change in serum proteins and patterns of proteinuria in 42 patients with idiopathic nephrotic syndrome(13 minimal change nephrotic syndrome-MCNS group, 7 focal glomerulosclerosis-FGS group, 12 membranous glomerulonphritis-MGN group and 10 patients with membranoproliferative glomerulonephritis Type I -MPGN group) cellulose acetate protein electrophoresis was done. Results: 1) In the percent composition of serum protein. the albumin and γ-globulin fraction of all the patient groups investigated decreased more significantly than those of the normal control group, but the α1-, α2-, γ-grobulin fraction increased(p<0.001, but that of α1-globulin of MGN group was p>0.05). 2) In the amount composition of serum proteins, the albumin and γ-globulin fraction of all the patient groups decreased more than those of the normal control group(p<0.001). The a-globulin fraction of MCNS group increased(p<0.001). but the β-globulin decreased(p<0.05). The α1-globulin fraction of FGS group decreased(p<0.01), but the α2-globulin increased(p<0.001). The α2-globulin fraction of MGN group increased(p<0.001). The α2-globulin fraction of MPGN group decreased(p<0.01). 3) In the percent composition of urine protein, the albumin fraction of FGS group showed the lowest value in comparison of the other groups, but the α1-, β-globulin fraction showed higher value. And the value of the α2-globulin fraction of MGN group was higher. A similar pattern appeared in the MCNS and the MPGN group. 4) 1n the amount composition of urine protein, the α1-, α2-, β-globulin fraction of FGS group, compared with the others, showed the highest value. Conclusion: The albumin fraction and the γ-globulin fraction in the percent composition of serum protein in patients with idiopathic nephrotic syndrome decreased and the fractions of α1-, α2-, β-globulin increased more than those of the normal control group. The α1-globulin fraction showed increased value regardless the level of serum albumin or proteinuria, but the α2, β-globulin showed and increased value according to decreases of serum albumin and increases of proteinuria. There were some differences in each disease group in serum protein composition, but that was insufficient when used as one of the criteria for differential diagnosis. A more sensitive method is needed in the evaluation of urine protein in idiopathic nephrotic syndeome.