高血压病患者早期肾损害的指标观察

The study of renad damages on early stage about hypertension

目的 观察高血压病患者的早期肾损害情况。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速率法测定尿肌酐。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 .0 1) ,并随病期的延长有逐渐增高的趋势。单项及两项检测RBP、mALB、β2 -MG、NAG阳性率较低 ,联合其中 3项检测阳性率较高 ,联合 4项检测阳性率可达 85 .1%。RBP与 β2 -MG、NAG呈显著正相关 (P <0 .0 5 )。mALB与RBP、β2 -MG、NAG无相关性 (P >0 .0 5 )。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 3- 4项指标有较高的检出率 ,对于高血压病肾病的早期诊断。

Objective To expore the renal damages on early stage about hypertension in the lab.Methods Urinary microalbumin(mALB) and β 2-microglodulin(β 2-MG) levels were measured with rate nepherometry. Total quantitative enzyme immunoassay was employed to measure urinary retinol binding protein(RBP) levels, rate for urinary N-acetyl-beta-D-glucosaminidase(NAG), and jaffes rate for urinary creatinine(Cr).Results The levels of urinary RBP, mALB, β 2-MG, NAG in hypertension patients were significantly higher than those in controls(P<0.01).The levels were increased gradually with the prolongation of patients condition. Measuring four markers together would raise the positive rate to 85.1% in hypertension patients. A significant positive correction was noted between urinary RBP and β 2-MG, NAG, bot no correction between mALB, and RBP, β 2-MG and NAG.Conclusion The method is sensitive to measure urinary RBP, mALB, β 2-MG and NAG in the diagnosis of early renal injury in hypertension patients. Measuring three or four markers together can get a higher positive rate. It is of value in detecting degree of injury to kidney in patients with hypertensive nephropathy.