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目的:探讨尿αn 1-微球蛋白(αn 1-mG)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、尿视黄醇结合蛋白(RBP)、尿βn 2-微球蛋白(βn 2-mG)联合检测在高血压肾早期损伤中的诊断价值。n 方法:选取2016年6月至2018年12月滕州市中心人民医院收治的高血压肾病患者116例(HRD组)和单纯高血压患者44例(HBP组)为研究对象，并与同期健康体检者36例(对照组)进行对照研究，HRD组116例根据慢性肾病(CKD)分期分为Ⅰ～Ⅱ期组61例和Ⅲ～Ⅴ期组55例，分别检测尿αn 1-mG、NAG、RBP、βn 2-mG水平，采用SPSS 19.0统计软件进行统计学分析。n 结果:HRD组尿αn 1-mG、NAG、RBP、βn 2-mG水平分别为(41.77±24.21)mg/L、(22.60±13.24)U/L、(2.86±1.73)mg/L、(1.76±0.95)mg/L，HBP组分别为(12.49±8.10)mg/L、(13.45±8.61)U/L、(0.31±0.16)mg/L、(0.38±0.38)mg/L，对照组分别为(4.37±2.52)mg/L、(6.12±3.57)U/L、(0.29±0.17)mg/L、(0.28±0.15)mg/L，HRD组明显高于HBP组(n t＝4.07、4.25、4.09、4.03，均n P<0.05)和对照组(n t＝3.15、4.94、2.49、2.61，均n P<0.05)。Ⅰ～Ⅱ期组尿αn 1-mG、NAG、RBP、βn 2-mG分别为(21.62±13.45)mg/L、(21.96±12.49)U/L、(0.5±0.47)mg/L、(0.93±0.62)mg/L，Ⅲ～Ⅴ期组分别为(64.11±60.12)mg/L、(23.32±14.11)U/L、(5.48±4.77)mg/L、(2.68±2.55)mg/L，Ⅰ～Ⅱ期组(n t＝5.08、4.99、2.96、1.66，n P<0.05)和Ⅲ～Ⅴ期组(n t＝3.95、4.81、4.33、3.74，均n P<0.05)尿αn 1-mG、NAG、RBP、βn 2-mG均明显高于对照组，Ⅲ～Ⅴ期组尿αn 1-mG、RBP、βn 2-mG明显高于Ⅰ～Ⅱ期组(n t＝5.37、8.11、4.52，均n P<0.05)。Ⅰ～Ⅱ期组检测阳性率αn 1-mG(70.5%)、NAG(77.0%)、RBP(19.7%)、βn 2-mG(60.7%)、联合检测(91.8%)，Ⅲ～Ⅴ期组检测阳性率αn 1-mG(81.8%)、NAG(81.8%)、RBP(69.1%)、βn 2-mG(69.1%)、联合检测(96.4%)，尿αn 1-mG、NAG、RBP、βn 2-mG、联合检测阳性率均明显高于单一检测(Ⅰ～Ⅱ期组χn 2＝7.71、3.99、61.4、14.65；Ⅲ～Ⅴ期组χn 2＝4.58、4.58、12.47、12.47；均n P<0.05)。n 结论:尿αn 1-mG、NAG、RBP、βn 2-mG可作为判定高血压肾早期损伤的指标，其水平变化与肾损伤程度相关；四项联合检测更有利于高血压肾早期损伤的临床诊断，有一定的临床应用价值。n “,”Objective:To investigate the diagnostic value of combined detection of urine α n 1-microglobulin(αn 1-mG), N-acetyl-β-D-glucosaminidase (NAG), retinol binding protein (RBP) and βn 2-microglobulin (βn 2-mG) for early hypertensive kidney injury.n Methods:From June 2016 to December 2018, 116 hypertension patients with renal damage (HRD group) and 44 cases with simple hypertension(HBP group) were selected in the Central People′s Hospital of Tengzhou in this study.And 36 cases of healthy people during the same period were selected as the control group.One hundred and sixteen cases of the HRD group were divided into Ⅰ-Ⅱ group (61 cases) and Ⅲ-Ⅴ group (55 cases) according to the classification of chronic kidney disease(CKD). The concentrations of α n 1-mG, NAG, RBP and β n 2-mG in urine were detected in patients and healthy people respectively.SPSS 19.0 software was used to perform statistical analysis.n Results:The concentrations of urine α n 1-mG, NAG, RBP, β n 2-mG in the HRD group were (41.77±24.21)mg/L, (22.60±13.24)U/L, (2.86±1.73)mg/L, (1.76±0.95)mg/L, respectively, which in the HBP group were (12.49±8.10)mg/L, (13.45±8.61)U/L, (0.31±0.16)mg/L, (0.38±0.38)mg/L, respectively, which in the control group were (4.37±2.52)mg/L, (6.12±3.57)U/L, (0.29±0.17)mg/L, (0.28±0.15)mg/L, respectively.The concentrations of urine α n 1-mG, NAG, RBP, β n 2-mG in the HRD group were significantly higher than those in the HBP group(n t=4.07, 4.25, 4.09, 4.03, all n P<0.05) and the control group(n t=3.15, 4.94, 2.49, 2.61, all n P<0.05). The urine levels of αn 1-mG, NAG, RBP, β n 2-mG in phase Ⅰ-Ⅱ group were (21.62±13.45)mg/L, (21.96±12.49)U/L, (0.5±0.47)mg/L, (0.93±0.62)mg/L, respectively, which in the phase Ⅲ-Ⅴ group were (64.11±60.12)mg/L, (23.32±14.11)U/L, (5.48±4.77)mg/L, (2.68±2.55)mg/L, respectively.The concentrations of urine α n 1-mG, NAG, RBP and β n 2-mG in Ⅰ-Ⅱ group (n t=5.08, 4.99, 2.96, 1.66, all n P<0.05) and Ⅲ-Ⅴ group (n t=3.95, 4.81, 4.33, 3.74, all n P<0.05) were significantly higher than those in the control group.The levels of αn 1-mG, RBP and β n 2-mG in group Ⅲ-Ⅴ were higher than those in group Ⅰ-Ⅱ(n t=5.37, 8.11, 4.52, all n P<0.05). The positive detection rates of αn 1-mG, NAG, RBP, β n 2-mG and combination test in phase Ⅰ-Ⅱ group were 70.5%, 77.0%, 19.7%, 60.7%, 91.8%, respectively, which in the phase Ⅲ-Ⅴ group were 81.8%, 81.8%, 69.1%, 69.1% and 96.4%, respectively.The positive rate of urine α n 1-mG, NAG, RBP and β n 2-mG combination test was significantly higher than that of the single detection (phase Ⅰ-Ⅱ group: χ n 2=7.71, 3.99, 61.4, 14.65; phase Ⅲ-Ⅴ group: χ n 2=4.58, 4.58, 12.47, 12.47; all n P<0.05).n Conclusion:Urine α n 1-mG, NAG, RBP and β n 2-mG are important biochemical indicators in patients with early hypertensive kidney injury.The combined detection of the four tests has high diagnostic value in the diagnosis of early hypertensive nephropathy.n