急性肾炎恢复期尿微量蛋白与尿酶检测的临床意义

Clinical significance of urinary microprotein and N acetyl beta D glucosaminidase in acute glomerulonephritis.

目的 探讨急性肾炎在临床治愈期尿微量蛋白联合尿酶检测的临床价值。方法 对 5 0例正常对照组和 30例急性肾炎组治愈期者采用酶联免疫吸附法检测尿微量白蛋白 (mALB)、视黄醇结合蛋白(RBP)、尿转铁蛋白 (TRF)和α1 微球蛋白 (α1 M ) ;终点法测尿N 乙酰 β D 氨基葡萄糖苷酶 (NAG) ;比色法测尿肌酐 (Cr)。结果 正常对照组尿mALB为 (3.6 1± 2 .4 6 )mg/L,RBP/Cr为 (7.4 6± 5 .0 2 ) μg/mmol,TRF/Cr为 (0 .0 5± 0 .0 3)mg/mmol,α1 M /Cr为 (0 .78± 0 .5 1)mg/mmol,NAG/Cr为(0 .5 2± 0 .4 6 )U/mmol,急性肾炎治愈期患者尿mALB为 (5 .12± 3.4 4 )mg/L ,RBP/Cr为 (8.87± 4 .4 5 ) μg/mmol,TRF/Cr为(0 .38± 0 .32 )mg/mmol,NAG/Cr为 (2 .13± 2 .0 2 )U/mmol,α1 M /Cr为 (0 .88± 0 .4 2 )mg/mmol;其检测的阳性率分别为 :mALB 4 0 % ,NAG 30 % ,RBP 13.3% ,TRF 2 0 % ,α1 M 3.3% ,NAG与mALB两项指标联合检测其阳性率为 4 6 .7%。结论 联合检测尿NAG与mALB在急性肾炎临床治愈期是判定肾脏损害及恢复情况的最灵敏与可靠的实验室指标。

Objective To study the clinical value of uninary microprotein and N acetyl beta D glucosaminidase(NAG) in acute glomerulonephritis.Methods Microalbumin(mALB),retinal binding protein(RBP),urinary transferring(TRF),and α 1 microglobulin(α 1 M) were measured with ELISA,NAG was measured by end point method and colorimetry was used for urinary creatinine(Cr)in 50 normal control group and 30 cases of acute renal glomerulonephritis.Results In normal controls,the levels of urinary NAG/Cr,RBP/Cr,mALB,TRF/Cr and α 1 M/Cr were (0.52±0.46)U/mmol,(7.46±5.02)μg/mmol,(3.61±2.46)mg/L, (0.05±0.03)mg/mmol and (0.78±0.51)mg/mmol,respectively.Positive rate of measuring NAG was 30%,mALB was 40%,RBP was 13.3% ,TRF was 20%,α 1 M was 3.3% and NAG mALB was 46.7%.Conclusion It is more sensitive and reliable to measure urinary NAG and mALB in diagnosis of early renal damage in acute glomerulonephritis.