Multi-Latex多聚粒技术联合检测尿微量蛋白在肾移植术后无创诊断中的应用价值

The application value of Multi-Latex polygranular technique joint detection of urinary microproteins in noninvasive diagnosis after renal transplantation

目的探讨Multi-Latex多聚粒技术联合检测肾损伤相关尿微量蛋白在肾移植术后无创诊断中的应用价值。方法回顾性分析72例肾移植受者的临床资料,根据血清肌酐(Scr)水平,分为肾功能正常组(A组,14例);肾功能轻度受损组(B组,37例);肾功能重度受损组(C组,21例);选取20例健康志愿者作为健康对照组(HC组)。采用Multi-Latex多聚粒技术检测上述各组研究对象的尿视黄醇结合蛋白(RBP)、微量白蛋白(mAlb)、IgG、转铁蛋白(TRF)、α1-微球蛋白(MG)和β2-MG含量。分析尿微量蛋白与Scr、血尿素氮(BUN)的相关性,比较各组尿微量蛋白差异,评价单一及联合检测尿微量蛋白的诊断价值。结果HC组和A组的6种尿微量蛋白均显著低于B组和C组,B组的6种尿微量蛋白均显著低于C组(均为P<0.01)。肾移植受者的6种尿微量蛋白均与BUN呈正相关,RBP、mAlb、α1-MG和β2-MG均与Scr呈正相关,相关性均有统计学意义(P<0.001~0.05)。尿微量蛋白联合检测的诊断价值优于单一指标的检测,其中TRF+mAlb+RBP+α1-MG四联检测诊断价值最高。结论6种尿微量蛋白可作为反映移植肾功能的特异性指标,多聚粒技术可同时检测其含量,实现无创诊断。基于TRF+mAlb+RBP+α1-MG四联检测的诊断有望进一步完善肾移植术后的无创诊断体系。

Objective To investigate the application value of Multi-Latex polygranular technique joint detection of kidney injury-related urinary microproteins in noninvasive diagnosis after renal transplantation.Methods Clinical data of 72 recipients undergoing renal transplantation were retrospectively analyzed.According to the level of serum creatinine(Scr),the recipients were divided into normal renal function group(group A,n=14),mild kidney injury(group B,n=37),and severe kidney injury group(group C,n=21).20 healthy volunteers were selected as the healthy control group(HC group).The contents of urinary retinol binding protein(RBP),microalbumin(mAlb),IgG,transferrin(TRF),α1-microglobulin(MG),andβ2-MG of subjects in each group were detected using the Multi-Latex polygranular technique.The correlation between urinary microproteins and Scr,blood urea nitrogen(BUN)was analyzed.The differences of urinary microproteins in each group were compared.And the diagnostic value of single and joint detection of urinary microproteins was evaluated.Results Six kinds of urinary microproteins in HC group and group A were significantly lower than those in group B and group C,and six kinds of urinary microproteins in group B were significantly lower than those in group C(all P<0.01).Six kinds of urinary microproteins in renal transplant recipients were positively correlated with BUN.RBP,mAlb,α1-MG,andβ2-MG were positively correlated with Scr.The correlations were statistically significant(P<0.001-0.05).The diagnostic value of joint detection of urinary microproteins is better than the detection of single index,among which TRF+mAlb+RBP+α1-MG quadruple detection had the highest diagnostic value.Conclusions Six kinds of urinary microproteins can be used as specific indicators to reflect graft renal function.The polygranular technique can simultaneously detect its contents and achieve noninvasive diagnosis.The diagnosis based on TRF+mAlb+RBP+α1-MG quadruple detection is expected to further improve the noninvasive diagnosis system after renal transplantation.