检测UM-Alb、NAG-U和Uβ_2-MG对诊断肝硬化早期肾损害的重要意义

Clinical significance of UM-Alb,NAG-U and Uβ_2-MG in diagnosis of early renal damage in cirrhosis patients

目的评价检测尿微量白蛋白(UM-Alb)、尿N-乙酰-β-D氨基葡萄糖苷酶(NAG-U)和尿β2-微球蛋白(Uβ2-MG)对诊断肝硬化早期肾损害的意义。方法采用双抗体夹心酶联免疫吸附法测定UM-Alb、β2-MG,采用对硝基酚比色法测定NAG-U。结果肝硬化组和肝肾综合征(HRS)组与正常对照组比较,Child A、B、C组与正常对照组比较,Child B、C组与Child A组比较,Child C组与Child B组比较,UM-Alb、NAG-U和Uβ2-MG水平均有统计学意义(P<0.01);肝硬化组与HRS组比较,UM-Alb、NAG-U和Uβ2-MG水平均无统计学意义(P>0.05)。UMAlb、NAG-U和β2-MG三者单独检测和联合检测的阳性率分别为:85.31%、79.02%、80.42%、94.41%。相关性分析表明,肝硬化患者的UM-Alb与NAG和Uβ2-MG水平均呈正相关(r=0.45,P<0.05;r=0.37,P<0.05)。结论 UM-Alb较NAG-U、Uβ2-MG更好的诊断肝硬化,三者联合检测在肝硬化的诊断中具有重要意义。

Objective To evaluate the value of detection of UM-Alb,NAG-U and Uβ2-MG in the diagnosis of early renal damage in cirrhosis patients. Methods Double antibody sandwich ELISA was used to detect the the contents of UM-Alb andβ2-MG,while the para-nitrophenol colorimetry was used to detect the NAG-U level. Results The contents of UM-Alb,β2-MG and NAG-U in cirrhosis group and hepato renal syndrome（HRS） group were all significantly higher than control group（P〈0. 01）. There was also statistical difference in UM-Alb,NAG-U and Uβ2-MG levels between Child A,B,C group and control group,Child B,C group and Child A group,Child B group and Child C group（P〈0. 01）. But there was no statistical difference between cirrhosis group and HRS group in UM-Alb,NAG-U and Uβ2-MG levels（P〉0. 05）. The positive rate of single UM-Alb detection was 85. 31%,that of NAG-U and Uβ2-MG were 79. 02% and 80. 42%,while that of joint detection of the three was 94. 41%. Correlation analysis showed that UM-Alb was positively correlated with NAG-U and Uβ2-MG levels in cirrhotic patients（r = 0. 45,P 0. 05; r = 0. 37,P〈0. 05）. Conclusion UM-Alb showed better diagnostic value in liver cirrhosis compared with NAG-U and Uβ2-MG. Combined detection of UM-Alb,NAG-U and Uβ2-MG is of great significance in the diagnosis of cirrhosis.