尿微量白蛋白、β_2-微球蛋白、NAG对肝硬化早期肾损害诊断意义

Study on the significance of measurement UM-Alb,Uβ_2-MG,NAG-U for diagnosis of cirrhosis with early renal lesion

目的研究尿微量白蛋白(UM-Alb)、尿β2-微球蛋白(Uβ2-MG)、尿N-乙酰-β-D氨基葡萄糖苷酶(NAG-U)对肝硬化患者早期肾损害诊断意义。方法对72例肝硬化患者、11例肝肾综合征(HRS)患者及35例体检正常者分3组,采用速率散射比浊法测定UM-Alb,Uβ2-MG,采用终点法测定NAG-U。结果肝硬化组UM-Alb,Uβ2-MG及NAG-U活性均明显高于正常对照组(均P<0.05),并且随child分级逐步升高,其间差异有显著性(均P<0.05)。结论UM-Alb,Uβ2-MG,NAG-U有助于早期发现肝硬化患者肾小球和肾小管的损害,并可反映随肝功能下降而加重的损害程度,对预测HRS的发生具有一定的意义。

Objective To study the significance of early renal injury in patients with cirrhosis whose urine test was normal with UM-Alb,Uβ2-MG,NAG-U measurement.Methods UM-Alb,Uβ2-MG,NAG-U were mea-sured in Seventy two patients with cirrhosis,eleven patients with hepatorenal syndrome and thirty five normal control subjects.Results Urinary levels of UM-Alb,Uβ2-MG and NAG-U were significantly higher in cirrho-sis group than that in control group,and became higher and higher in child A、B and C stage（all of P0.05）.Conclusion UM-Alb,Uβ2-MG and NAG-U are sensitive and useful items for the diagnosis of early glomerular and tublar lesions in patients with cirrhosis,and those index become higher gradually with the hepatic function damage and play a role in the detection of the hepatorenal syndrome.