尿微量蛋白测定对肝硬化早期肾损害诊断的意义

Significance of measuring microproteinuria for diagnosis of cirrhosis with early renal lesion

目的:探讨检测尿微量蛋白及尿N-乙酰-β-D氨基葡萄糖苷酶(NAG)对尿常规正常的肝硬化患者肾损害诊断的价值。方法:41例肝硬化患者及20例体检正常者,用速率散射比浊法测定尿白蛋白、尿α1-微球蛋白、尿β2-微球蛋白、尿免疫球蛋白G值,用分光光度法测定尿NAG的活性。结果:肝硬化组各种尿微量蛋白值及NAG活性均明显高于对照组(均P<0.01),且随肝功能Child分级逐步升高,其间差异有非常显著性(均P<0.01)。结论:尿微量蛋白值及NAG活性测定有助于早期发现肝硬化患者肾小球和肾小管损害的存在,并且能反映这种随肝功能下降而加重的损害程度。

Objective： To explore the diagnoset value of the renal lesion of patients with cirrhosis whose urine routine test was normal by microproteinuria and N-acetyl-β-D-glucosaminidase （NAG） measurement. Methods： Urinary albumin（Alb）, α1-microgloubulin （α-MG）,β-microgloubulin （β 2-MG）,immunoglobulin G IgG） and NAG were measured in 41 patients with cirrhosis and 20 healthy people. Results：Urinary levels of Alb,α1 -MG, β2-MG, IgG and NAG were significantly higher in cirrhosis group than that in control group （all of P〈 0.01）, and became higher and higher in Child A,B and C stage （all of P〈 0.01）. Conclusion： The microproteinuria and NAG measurement may be helpful to diagnose the early glomerular and tubular lesions of the patients with cirrhosis, and those index became higher gradually with the hepatic function damage.