免疫胶体金快速试纸条法检测尿视黄醇结合蛋白4对肾移植患者肾功能不良状态的评估价值

Value of urine retinol-binding protein 4 detetcted by colloidal gold immunochromatography assay in evaluating renal dysfunction in kidney transplant patients

目的研究免疫胶体金快速试纸条法检测尿视黄醇结合蛋白4（RBP4）对肾移植患者肾功能不良状态的评估价值。方法选取本中心随访的141例肾移植术后患者为研究对象,分别以酶联免疫吸附（ELISA）法和免疫胶体金快速试纸条法测定尿中RBP4含量,采用kappa检验评价两种方法的一致性。根据免疫胶体金快速试纸条法检测结果呈现深红、浅红和无显色分别代表RBP4高、中、低浓度,将患者分为3组,分析患者临床检测指标与RBP4结果间的关系。结果以ELISA方法和免疫胶体金快速试纸条法在检测肾移植患者尿RBP4方面高度一致（kappa=0.813,95%CI：0.763-0.933）。根据免疫胶体金快速试纸法结果,不同浓度RBP4组间在空腹血糖（P=0.028）、血肌酐（P=0.021）、血尿素氮（P=0.012）、血白蛋白（P=0.014）、血红蛋白（P=0.026）、尿蛋白（P=0.015）等方面差异有统计学意义。结论以免疫胶体金快速试纸条法检测尿RBP4浓度,可根据试纸条反应颜色达到半定量检测的目的,其结果可靠、灵敏、操作快捷,便于移植术后患者随访过程中早期发现肾小管损害。

Objective To explore the value of urine retinol-binding protein 4（RBP4）detected by colloidal gold immunochromatography assay in evaluating the renal dysfunction state in kidney transplant patients.Methods A total of 141 kidney transplant patients followed-up by our urology center were included in this study.The RBP4 levels in the urine of the participants were measured by both enzyme-linked immunosorbent assay（ELISA）and colloidal gold immunochromatography assay.The consistency of the two methods was evaluated by kappa test.The patients were divided into three groups according to the results of colloidal gold immunochromatography assay,in which dark red,light red and colorless representing the low,medium and high levels of RBP4,respectively.The relationship between patient clinical manifestations and RBP4 results was analyzed.Results The two methods of ELISA and colloidal gold immunochromatography assay showed high consistency in detecting RBP4 concentration in the urine of kidney transplant patients（kappa=0.813,95%CI：0.763-0.933）.According to the results of colloidal gold immunochromatography assay,the low,medium and high levels RBP4 groups had significantly different fasting glucose（P=0.028）,serum creatinine（P=0.021）,blood urea nitrogen（P=0.012）,albumin（P=0.014）,hemoglobin（P=0.026）and proteinuria（P=0.015）.Conclusion Colloidal gold immunochromatography assay detecting urine retinol binding protein 4can achieve semi-quantitative results via reaction color of the strip.It is reliable,sensitive and easy to perform,making it easy for the early diagnosis of renal tubular injury after kidney transplantation during follow-up.