β2-MG诊断急性有机磷农药中毒急性肾损伤的价值

Value of β2-MG in the Diagnosis of Acute Kidney Injury Induced by Acute Organophosphate Pesticide Poisoning

目的了解血清β2-微球蛋白(β2-MG)诊断急性有机磷农药中毒(AOPP)急性肾损伤(AKI)的价值。方法 81例AOPP患者根据其乙酰胆碱酯酶水平分为轻度组(31例)、中度组(29例)、重度组(21例)。同期门诊体检健康者30例为对照组。分别检测各组血清肌酐(Scr)、β2-MG含量;分析β2-MG诊断AKI的特异度、灵敏度。结果 AOPP时AKI的总发生率为76.5%(62/81),轻、中、重度组AKI发生率分别为45.2%(14/31)、93.1%(27/29)、100.0%(21/21)。β2-MG诊断AOPP致AKI的总体灵敏度、特异度分别为46.8%(29/62)、100.0%。各中毒组的β2-MG阳性率依次为0%(0/31)、34.5%(10/29)、90.5%(19/21),重度组>中度组>轻度组(P<0.01)。β2-MG含量及阳性率与中毒程度均呈负相关关系(P<0.05)。结论β2-MG诊断AOPP致AKI的灵敏度、阳性率低,不是早期诊断AKI的敏感指标。

Objective To explore the value of β2-microglobulin（[32-MG） in the diagnosis of acute kidney injury（AKI） induced by acute organophosphate pesticide poisoning （AOPP）. Methods Eighty one patients with AOPP were divided into three groups （ mild poisoning group, moderate poisoning group and severe poisoning group） according to acetylcholinesterase （AchE） level. Thirty healthy controls in out-patient clinic were also recruited. Creatinine （Scr）,β2-MG were detected in each group, and β2-MG was analyzed to diagnose the specificity and sensitivity of AKI. Results The total incidence of AKI induced by AOPP was 76.5% （62/81） ,the incidences of mild poisoning group, moderate poisoning group and severe poisoning group were 45.2% （ 14/31 ）, 93.1% （27/29） and 100.0% （21/21 ）, respectively. The total specificity and sensitivity of β2-MG in the diagnosis of AKI induced by AOPP were 46.8% （29/62）, 100.0%, respectively. The positive rates of β2-MG in each poisoning group were 0% （0/31）,34.5% （10/29） and 90.5% （ 19/21 ） ,which was the highest in the severe poisoning group but the lowest in the mild poisoning group（P 〈0.01 ）. The concentration and positive rate of β2-MG had a negative correlation with intoxication degree （P 〈 0.05 ）. Conclusion The specificity and sensitivity of β2-MG in the diagnosis of AKI induced by AOPP are low,which can not be the sensitive marker for early diagnosis of AKI induced by AOPP.