【摘要】 目的探讨高血压病患者早期肾脏损害尿蛋白指标的变化及对高血压肾病的诊断价值。方法采用速率散射比浊法检测尿微量白蛋白(mALB)、β2-微球蛋白(β2-MG),全定量酶免疫法测定尿视黄醇结合蛋白(RBP),速率法检测N-乙酰-β-D-氨基葡萄糖苷酶(NAG),Jaffe速率法测定肌酐。结果高血压病患者尿RBP、mALB、β2-MG、NAG均较对照组显著增高(P<0.01),并随病期的延长有逐渐增高的趋势。单项及二项检测RBP、mALB、β2-MG、NAG阳性率较低,联合其中三项检测阳性率较高,联合四项检测阳性率可达91.67%,RBP与β2-MG、NAG呈显著正相关(P<0.05)。mALB与RBP、β2-MG、NAG无相关性(P>0.05)。结论检测尿RBP、mALB、β2-MG、NAG是诊断高血压病早期肾损害的敏感指标,联合三至四项指标有较高的检出率,对于高血压肾病的早期诊断,肾功能损害程度及部位的判断具有一定的价值。更多还原

【Abstract】 Objective To evaluate the clinical significance of using urinary proteins as indicators in hypertension patients with early renal impairment. Methods Rate nepheroetry was employed to measure the levels of urinary microalbumin (mALB) and β2-microglodulin (β2-MG). Total quantitative enzyme immunoassay was used to measure the levels of urinary retinol binding protein (RBP). Velocity Method was used for the determination of urinary N- acetyl-beta-D-glucosaminidase (NAG) and Jaffes rate was used for the measurement of urinary creatinine (Cr). Results The levels of urinary RBP, mALB, β2-MG and NAG in hypertension patients were significantly higher than the healthy subjects (P<0.01). The levels of these four urinary proteins were elevated gradually with the prolongation of the hypertensive status. The combined analysis of these four proteins would raise the positive detection rate to 91.67% in hypertension patients. The level of urinary RBP was positively correlated with β2-MG and NAG, but there was no correlation between mALB and RBP, β2-MG and NAG. Conclusion RBP, mALB, β2-MG and NAG can be used in the diagnosis of early renal impairment in hypertension patients. The combined analysis of three or four of these marker proteins can increase the positive detection rate. It can also be used to indicate the degree of severity of renal impairment in patents with hypertensive nephropathy.更多还原