原发性高血压患者尿微量蛋白测定的临床意义

The clinical meaning of determination of four kinds of urine microproteins in essential hypertension

目的 探讨尿内 4种微量蛋白 :白蛋白 (Alb)、转铁蛋白 (Tf)、免疫球蛋白 (IgG)、α1-微球蛋白 (α1-MG)的改变对原发性高血压患者早期肾损害的诊断价值。方法 选取原发性高血压Ⅰ、Ⅱ期患者 (EHⅠ、EHⅡ )及正常健康人 (对照组 )各 30例 ,观察和比较其尿液中 4种微量蛋白的量。结果 尿 4种微量蛋白的测定值 (mg/L) ,对照组依次为 :(4 94± 2 6 1)、 (0 99± 0 0 8)、 (4 6 3± 1 6 2 )、 (4 6 3± 0 93) ;EHⅠ组 :(18 0 0± 12 30 )、 (1 43± 1 0 4)、 (5 92± 4 30 )、 (10 0 0± 3 2 3) ;EHⅡ组 :(32 6 6± 2 1 6 6 )、 (2 90± 2 97)、(9 45± 7 95 )、 (12 84± 6 84)。除IgG含量在对照组和EHⅠ组之间差异无统计学意义外 ,其余各种尿蛋白含量各组之间差异均有统计学意义 (P <0 0 5～ 0 0 1)。结论 尿微量蛋白的测定是发现早期肾损害的敏感指标 ,其排泄量与高血压的病变程度有关。

Objective To investigate the diagnostic value of four kinds of urine microproteins in early renal injury in patients with essential hypertension.Methods Levels of four kinds of urine microproteins:albumin(Alb),transferrin(Tf),immunoglobulin-G(IgG) and α 1-microglobulin(α 1-MG) were measured in three groups:30 normal control subjects,30 patients with stageⅠ essential hypertension(EHⅠ),30 patients with stageⅡ essential hypertension(EHⅡ).Results Comparing the levels of the corresponding urine microproteins we found there were difference among 3 groups:normal control group:4 94±2 61、0 99±0 08、4 63±1 62、4 63±0 93 ,EHⅠ:18±12 30、1 43±1 04、5 92±4 30、10±3 23,EHⅡ:32 66±21 66、2 90±2 97、9 45±7 95、12 84±6 84.Therefore the levels of urine Alb、Tg、α 1-MG in EHⅠ were significantly higher than those in normal control group(P<0 05～0 01),and the levels of urine proteins of all kinds were also higher in EHⅡ than those in normal control group and in EHⅠ.(P<0 05～0 01).Conclusion The mensuration of the urine microprotein is a sensitivity method to find out the early renal injury in essential hypertension.The alternation of urine microprotien excretion is closely related to the classification of the stage of EH.