高胆红素血症患者尿液微量蛋白、胱抑素C及尿常规检测对早期肾功能损伤的诊断价值

Diagnostic Value of Urine Microprotein,Cystatin C and Urine Routine Detection in Patients with Hyperbilirubinemia for Early Renal Injury

目的探讨高胆红素血症患者尿液微量蛋白、胱抑素C及尿常规检测在早期肾功能损伤中的诊断价值。方法选取西京医院临床科室2016年3～12月间中、重度高胆红素血症(TBIL>171μmol/L)患者160例为高胆红素血症组,同时选取同期正常查体人员100例为正常对照组,比较两组尿液微量蛋白[尿α1-微球蛋白(尿α1-MG),尿β2-微球蛋白(尿β2-MG)],尿液常规[尿胆红素(尿BIL),尿沉渣镜检肾小管上皮细胞],肾功能[血清胱抑素C(Cys C),肌酐(Cr),尿素氮(BUN)]水平和阳性率。结果高胆红素血症组尿α1-MG,尿β2-MG,尿BIL和血清Cys C与正常对照组水平比较,差异均有统计学意义(t=-8.328,-2.669,-31.86,-8.246,均P<0.01),BUN和Cr差异无统计学意义(t=-0.629,2.769,均P>0.5);高胆红素血症组尿α1-MG,尿β2-MG,尿BIL,血清Cys C和尿沉渣镜检肾小管上皮细胞与正常对照组阳性率比较,差异均有统计学意义(χ~2=260.000,45.549,251.654,68.734,247.694,均P<0.01)。结论尿α1-MG,尿β2-MG,血清CysC,尿BIL和尿沉渣镜检肾小管上皮细胞检测可提示中、重度高胆红素血症引发的早期肾功能损伤情况。

Objective To investigate the diagnostic value of urine microprotein,cystatin C and urine routine detection in pa dents with hyperbilirubinemia in early renal injury. Methods A total of 160 patients with moderate to severe hyperbilirubi hernia （TBIL〉171 μmol/L） from March to December 2016 in clinical department of the Xijing Hospital were enrolled in the high bilirubin group,and at the same time, 100 normal physical examination personnel were selected as the normal control group. Comparison of urine microalbuminuria E al microglobulin （urine al MG）, urine β2 microglobulin （urine β2 MG）1, u fine routine urinary Ebilirubin （urine BIL）, urine sediment Microscopic examination of renal tubular epithelial cells], renal function [serum cystatin C （Cys C） ,creatinine （Cr） ,urea nitrogen （BUN）] level and positive rate. Results The levels of u rinary al MG, urinary β2 MG, urinary BIL, and serum Cys C in the hyperbilirubinemia group were significantly different from those in the normal control group （t= 8. 328, 2. 669, 31.86, 8. 246, both p〈0.01）, but difference of BUN, Cr was not statistically significant （t= 0. 629,2. 769, both p〈0.5）, urinary al MG, urine β2 MG, urine BIL, serum Cys C and the positive rate of renal tubular epithelial cells in urine sediments of hyperbilirubinemia group were compared with the normal control group was statistically significant （x2 = 260. 000,45. 549,251. 654,68. 734,247. 694, both p〈0.01）. Conclusion Urine al MG,urine β2 MG, serum Cys C, urinary BIL, urine sediment microscopic examination of renal tubular epithe lial cells may indicate early renal damage caused by moderate and severe hyperbilirubinemia.