血清同型半胱氨酸和β2-微球蛋白检测对体外冲击波碎石术后肾功能损伤的评估价值

The role of serum homocysteine and β2-microglobulin in the evaluation of renal function after extracorporeal shock wave lithotripsy

目的探讨血清同型半胱氨酸(Hcy)及β2-微球蛋白(β2-MG)检测对体外冲击波碎石(SWL)术后肾功能损伤的评估价值。方法选择58例在我院行SWL术患者,分别检测SWL术前、术后24h、3d、7d、1月血清肌酐(SCr)、血清Hcy及β2-MG水平。分析术后血清Scr、Hcy及β2-MG阳性检出率,术前、术后血清SCr、Hcy及β2-MG变化。结果术后24h血清Scr、Hcy及β2-MG阳性检出率分别为3.4%、94.8%和93.1%,术后第3天为1.7%、86.2%和81.0%,术后第7天为0%,34.5%和27.6%,术后1月为0%、8.6%和5.2%。血清Hcy及β2-MG在术后24h(血清Hcy:术前vs.术后24h,P<0.01;血清β2-MG:术前vs.24h,P<0.01)、3d(血清Hcy:术前vs.术后3d,P<0.01;血清β2-MG:术前vs.术后3d,P<0.01)显著上升,与术前相比具有统计学差异,血清Hcy及β2-MG在术后第7天下降至正常水平。Scr水平在术后24h上升(P<0.05),与术前相比有统计学差异,术后第3天尽管有上升,但与术前相比无统计学差异(P>0.05)。结论血清同型半胱氨酸及β2微球蛋白联合评估SWL术后肾功能损伤具有重要价值,并且可为再次行SWL术提供治疗时间参考。

Objective To explore the value of serum homocysteine（Hcy）andβ2-microglobulinin（β2-MG）in the evaluation of renal function after extracorporeal shock wave lithotripsy（SWL）.Methods A total of 58 patients with kidney stones treated with SWL in our hospital during Jan.2013 and Apr.2014 were collected.Serum Scr,Hcy andβ2-MG were detected before operation,24 hours,3 days,7 days and1 month after operation.Results The abnormal rate of Scr,Hcy andβ2-MG24 hours,7 days,and1 month after SWL were：3.4%,94.8% and93.1%;1.7%,86.2% and81.0%;0%,34.5% and27.6%;0%,8.6% and 5.2%.The serum levels of Hcy andβ2-MG were significantly increased 24 hours and 3 days after SWL compared with those before operation（all P0.01）.The Scr level was also increased 24 hours and 3 days after SWL,but there was no difference between the values pre-SWL and3 days after operation（P0.05）.Conclusion Serum homocysteine andβ2-microglobulin could serve as markers to evaluate renal function after SWL and provide reference for the timing of next SWL.