上尿路结石致肾积水手术前后检测β_2M的临床意义

Pre-and post-operative urinary β_2-microglobulin in urolithiasis complicating hydronephrosis

对２２例上尿路结石所致肾积水患者手术前后病侧肾脏尿液中β２Ｍ微球蛋白（β２Ｍ）含量进行放免检测。术前所有患者病肾尿中β２Ｍ含量均明显高于正常。肾积水越重，其术前及术后尿中β２Ｍ含量越高；反之越低。合并感染患者，其术前及术后病肾尿中β２Ｍ含量较未感染者明显增高。术后两周时，轻度肾积水患者病肾尿中β２Ｍ含量较术前显著降低；但中度及重度肾积水患者病肾尿中β２Ｍ含量无明显降低。结果提示：肾积水越重，肾功能损害越严重，肾功能恢复所需时间也更长；合并感染可加重病肾肾功能的损害。

Urinary β2-microglobulin(β2M) was assessed by radioimmunoassay in 22 upper urinary tract urolithiasis patients complicating hydronephrosis.The preoperative urinary β2M was significantly elevated in all and the elevation was parallel to the severity of the hydronephrosis.When superimposed by infection,the urinary β2M was further elevated.If the hydronephrosis has been mild,the urinary β2M usually dropped significantly two weeks after surgical intervention.This phenomenon was not observed if the hydronephrosis has been moderate or severe.It was concluded that the severer the hydromephrosis the worse the renal function.Superimposed infection further deteriorated the function of a hydronephrotic kidney.