系统性红斑狼疮患者4种尿微量蛋白检测结果分析

The Result Analysis of Four Kinds of Urine Microprotein in Systemic Lupus Erythematosus

目的探讨尿微量白蛋白、转铁蛋白、α1-微球蛋白、β2-微球蛋白在SLE患者早期肾损害监测中的意义。方法 SLE患者108例,依据是否有肾脏的临床表现分为两组:有肾脏表现组和无肾脏表现组。65名健康献血者为正常对照组。收集受检者晨起第2次尿液,采用免疫散射比浊法定量检测尿微量白蛋白、转铁蛋白、α1-微球蛋白、β2-微球蛋白。血清尿素氮、肌酐的检测采用全自动生化仪(东芝120)检测。结果有肾脏表现组4种微量蛋白均高于无肾脏表现组和对照组(P<0.05),无肾脏表现组4种微量蛋白均高于对照组(P<0.05)。4项指标单独检测的阳性率在无肾脏表现组、有肾脏表现组组内比较,差异均无统计学意义(P>0.05)。而分析4种微量蛋白联合检测阳性率的结果,发现在无肾脏表现组1项指标阳性率与2项指标阳性率比较,3项指标阳性率与4项指标阳性率比较,差异无统计学意义(P1,2;P3,4>0.05)。而1项指标阳性率与3项指标阳性率比较,与4项指标阳性率比较;2项指标阳性率与3项指标阳性率比较,与4项指标阳性率比较,差异有统计学意义(P1,3;P1,4;P2,3;P2,4<0.05)。在有肾脏表现组结果与无肾脏表现组结果相同。有肾脏表现患者的尿中微量白蛋白、转铁蛋白、α1-微球蛋白、β2-微球蛋白与血清尿素氮之间无统计学相关性;尿中转铁蛋白、α1-微球蛋白、β2-微球蛋白与血清肌酐之间无统计学相关性,P>0.05;而尿微量白蛋白与血清肌酐之间呈正相关,r=0.737,P<0.05。结论 4种指标联合检测可以大大提高阳性检出率,提示系统性红斑狼疮患者早期动态观察监测尿微量蛋白的类型与含量,对患者肾早期损伤的诊断具有非常重要的临床价值。

Objective To explore the significance of the urine microalbumin,transferrin,alpha 1-microglobulin,beta 2-microglobulin in SLE patients with early renal damage.Methods One hundred and eight patients with SLE,based on whether had the clinical manifestations of the kidney,were divided into two groups,obvious lupus nephritis group and silent lupus nephritis group,sixty-five healthy donors for normal control group.Immunol scatter turbidity test was used to assay microalbumin,transferrin,alpha 1-microglobulin,beta 2-microglobulin.The automatic biochemistry analyzer（Toshiba 120） was used to assay Serum BUN and Cr.Results The four kinds of microprotein in obvious lupus nephritis group were higher than that in silent lupus nephritis group and the control（P0.05）.The four kinds of microprotein in silent lupus nephritis group were higher than those in the control group（P0.05）.There were no statistical significance of four performance alone in obvious lupus nephritis group and in silent lupus nephritis group（P0.05）.The four kinds of microprotein were jointly tested in Silent Lupus nephritis group.It＇s found that there was no statistical significance in positive frequency comparing to one index and two indexes,three indexes and four indexes（P 1,2;P3,40.05）.However there was statistical difference in comparing one index and three indexes,one index and four indexes,two indexes and three indexes,two indexes and four indexes（P 1,3;P 1,2;P 2,3;P 2,40.05）.The result in obvious lupus nephritis group was the same.There was no relationship between urine microalbumin,transferrin,alpha 1-micro globulin,beta 2-micro globulin and serum BUN.There was no statistics correlation between urine transferrin,alpha 1-micro globulin,beta 2-micro globulin and serum creatinine（P0.05）.While there was positive relationship between urinary microalbumin and serum creatinine（r=0.737,P0.05）.Conclusion The four index united detection can greatly improve the positive rate,indicating the significiance of dynamic monitoring the types and content of urine microprotein to early diagnosis of renal injury in SLE.