慢性乙型肝炎、肝硬变患者尿微量蛋白检测的临床意义

CLINICAL SIGNIFICANCE OF DETERMINATION OF TRACE PROTEINURIA IN CHRONIC B HEPATITIS AND LIVER CIRRHOSIS

采用放射免疫分析法检测了尿蛋白定性检查呈阴性反应的慢性乙型肝炎、活动性肝硬变59例患者尿微量白蛋白(UALb)、尿免疫球蛋白G(UIgG)、尿β_2-微球蛋白(Uβ_2m)和尿Tamm-Horsfall蛋白(THP)。109名健康人为对照组。结果:59例患者中17例UALb排泄量显著增加,与对照组比较,差异有显著性(P<0.001);其中5例UIgG排泄量增加。UALb排泄量增加的17例患者中,16例Uβ_2m排泄量增加,9例THP排泄量减少,与对照组比较,均有显著性意义(P<0.001)。检测结果表明:乙型肝炎病毒持续感染可造成患者肾脏损伤,可同时累及肾小球及肾小管。检测UALb、UIgG,Uβ_2m和THP有助于发现肾脏早期损伤及损伤部位。

Urinary microquantitative albumin (UALb), immunoglobulin G (UIgG) β2-microglo-bulin (Uβ2m), and Tamm-Horsfall protein (THP) were measured in 36 chronic B hepatitis (CHB) and 23 liver cirrhosis (LC) patients with radioimmunoassay. 109 healthy normal subjects served as controls. The results showed that the excretion of UALb was significantly increased in 17 patients. Out of 17 patients,the excretion of UIgG in 5 and Uβ2m in 16 were increased and the excretion of THP in 9 patients were decreased. Compared with normal controls there was a significant difference (P<0.001). Our results suggest that the renal lesions exist not only in the glomeruli but also in the proximal and distal tubules in patients with CBH and LC. The determination of UALb, UIgG, Uβ2m, and THP in CHB and LC is helpful to detect the early renal lesions and the sites of the renal lesions.