소아 신장질환에서 혈청 및 뇨 β2-Microglobulin치의 의의

Abstract

[영문]

[한글]

β^^2 -microglobulin (β^^2 -M)은 분자량이 11,800인 저분자량 단백으로 유핵세포막

에 존재하며 체액에 분포하는 물질로서, 대사는 신장에서 이루어진다. β^^2 -M은 신사구

체를 잘 통과하여 대부분 근위세뇨관에서 재흡수되어 대사된다. β^^2 -M은 뇨배설량이

감소하는 경우에 혈청농도가 증가되며, 신세뇨관장애가 있을때 뇨중 배설량이 증가된다.

이에 저자는 소아 신장질환에서 β^^2 -M의 임상적 의의를 알아보고 혈청 creatinine, 사

구체여과율과의 상관관계를 고찰하고자, 1985년 4월부터 1986년 1월까지 연세대학교 의과

대학 영동세브란스병원 소아과에 입원했던 신장질환 환아 134예와 대조군 83예를 대상으

로 혈청 및 뇨 β^^2 -M치를 측정하였다.

신장질환군에서의 혈청 β^^2 -M치는 3.27 ±0.33 ㎎/L (mean±S.E.), 뇨 β^^2 -M량은

022±0.04㎎/day로 각각의 대조군의 2.35±0.07㎎/L, 0.11±0.02㎎/day에 비해 유의하게

높았다.

각 신장질환별로 혈청 β^^2 -M치는 급성신부전증에서 16.75±6.79㎎/L, 만성신부전증

에서 15.08±5.91㎎/L, 요로기형에서 2.76±0.23㎎/L로 각각 대조군에 비해 현저히 증가

되었고, 사구체여과율의 감소가 없는 사구체질환에서도 2.58±0.10㎎/L로 유의한 증가를

보였다.

신장질환군에서 혈청 β^^2 -M치는 혈청 creatinine치와는 비례적 상관관계 (r=0.97)를

, creatinine제거율과는 역상관관계(r=-0.34)를 보였다.

뇨 β^^2 -M량은 급성신부전증에서 1.05±0.58㎎/day로 대조군에 비해 현저히 증가되었

고, 요로기형에서 0.25±0.13㎎/day, 사구체질환에서 0.17±0.03㎎/day로 각각 유의하게

증가되었다.

이상의 결과로 소아 신장질환에서 β^^2 -M측정은 신장기능을 평가하는 감수성 높은 지

표가 될 수 있다고 생각된다.

A Study On β^^2 -Microglobulin in Renal Diseases of Childhood

Ki Suk Bahn

Department of Pediatrics The Graduate School, Yonsei University

(Directed by Professor Pyung-Kil Kim. M.D.)

Beta 2 microglobulin (β^^2 -M), a low molecular weight protein, exists in the

plasma membrane of all nucleated cells and is also found in other biological fluid

and degraded via the kidney. It passes across the glomerular membrane easily and is

normally reabsorbed to a high extent in the renal tubule where it is catabolized.

As a result, the level of serum β^^2 -M is increased when the glomerular

filtration rate is reduced and that of urine β^^2 -M is increased in disorders

affecting the tubule. The author attempted to assess the clinical significance of

serum and urine β^^2 -M levels in renal diseases of childhood and to assess

correlation between the serum β^^2 -M level and serum creatinine level, creatinine

cleatrance respectively. Serum and urine β^^2 -M levels were measured on a total

of 134 proven renal disease patients at Yong Dong Severance Hospital, Yonsei

University, College of Medicine from April 1985 to January 1986. As a control

group, the serum and urine β^^2 -M levels of 83 patients wert also measured during

the same period with study group. The control group were excluded renal disorders,

malignancy, autoimmune disease and chronic inflammatory disease.

The results were as follows

1. The mean level of serum β^^2 -M in renal diseases was 3.27±0.33mg/, that of

urine β^^2 -M was 0.22±0.04mg/day, both of which were significantly increased

over those of the control group.

2. The mean level of serum β^^2 -M was 16.75±6.09mg/L in acute renal failurer

15.08±5.91mg/L in chronic renal failure and 2.76±0.23mg/L in urologic anomalies,

which were markedly increased over those of the control group. In glomerular

diseases, even though the glomerular filtration rate was not decreased, the mean

level of serum β^^2 -M was 2.58±0.10mg/L, which was increased significantly.

3. In renal disease group, the serum β^^2 -M level was closely correlated with

the serum creatinine level (r=0.97), but reversely correlated with creatinine

clearance (r=-0.34).

4. The mean level of urine β^^2 -M was 1.05±0.58mg/day in acute renal failure,

0.25±0.13mg/day in urologic anomalies and 0.17±O.03mg/day in glomerular diseases,

which were significantly increased over those of the control group.

From these results, it can be suggested that determination of the level of serum

and urine β^^2 -M are a valuable laboratory aid in the evaluation and

differentiation of renal diseases in childhood.