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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。
Objective To investigate the changes of urinary protein in patients with hypertension and its clinical significance in the diagnosis of hypertensive nephropathy. Methods Urine microalbumin (mALB) and β2-microglobulin (β2-MG) were measured by rate nephelometry. Urinary retinol binding protein (RBP) was measured by enzyme-linked immunosorbent assay (ELISA) β-D-glucosaminidase (NAG), Jaffe rate method for the determination of creatinine. Results Urine RBP, mALB, β2-MG and NAG in hypertensive patients were significantly higher than those in the control group (P <0.01), and gradually increased with the prolongation of the disease duration. The detection rates of RBP, mALB, β2-MG and NAG were lower in one and two tests. The positive rates of three tests were higher, the positive rates of four tests were 91.67%, RBP and β2-MG, NAG were significantly positive Related (P <0.05). No correlation was found between mALB and RBP, β2-MG and NAG (P> 0.05). Conclusion The detection of urinary RBP, mALB, β2-MG, NAG is a sensitive index for the diagnosis of early renal damage in patients with hypertension. Combined with three to four indicators, the detection rate is high. For the early diagnosis of hypertensive nephropathy, the degree of renal dysfunction And part of the judgment has a certain value.