尿微量蛋白联合尿酶诊断高血压早期肾损害

Diagnosis of early renal damage due to hypertension with uninary micro-proteins and N-acetyl-beta-D-glucosaminidase

目的 探讨高血压早期肾损害诊断标准。方法 对 5 0例健康者 (对照组 )和 5 0例高血压患者采用 EL ISA方法检测尿转铁蛋白 ( TRF)、微量白蛋白 ( m AL B)和尿视黄醇结合蛋白 ( RBP) ,终点法测尿 N-乙酰 - β- D-氨基葡萄糖苷酶 ( NAG) ,比色法测尿肌酐。结果 正常对照组尿 TRF/ Cr为 0 .0 5± 0 .0 3 mg/ mmol,m AL B为 3 .61± 2 .46m g/L,RBP/ Cr为 7.46± 5 .0 2 μg/ mm ol,NAG/ Cr为 0 .5 2± 0 .46U/ m mol,尿蛋白定性阴性的高血压患者 TRF/ Cr、m AL B、RBP/ Cr及 NAG/ Gr值较正常对照组增高 ( P<0 .0 1) ;两项指标联合检测其阳性率分别为 :TRF+ m AL B为 62 % ,TRF+ NAG为 5 4% ,m AL B+ NAG为 44 % ,将这三项指标联合检测可使阳性率提高到 78% ,大大提高了阳性检出率。结论 联合检测尿 TRF、m AL B及 NAG是诊断高血压早期肾损害的灵敏。

Objective To study diagnostic markers for early renal damage due to hypertension Methods Urinary transferrin (TRF),microalbumin(mALB)and retinal binding protein(RBP)were measured with ELISA,End-pointmethod for urinary N-acety1-beta-D-glucosaminidase(NAG),and colorimetry for urinary creatinine(Cr).Results In normal controls,the levels of uninary TRF/Cr?mALB?RBP/Cr and NAG/Cr were 0.05±0.03mg/mmol,3.61±2.46mg/L,7.46±5.02μg/mmol and 0.52±0.46U/mmol respectively;The levels of uninary TRF/Cr?mALB?RBP/Cr and NAG/Cr in hypertension patients with negative for urinary protein quality were significantly higher than in controls(P<0.01).Positive rate of measuring TRF and mALB was 62%,that of measuring TRF and NAG was 54% and that of measuring mALB and NAG was 44%;Measuring three markers would raise positive rate to 78%. Conclusion It is more sensitive and credible markers to measuring urinary TRF,mALB and NAG in diagnosis of early renal damage in hypertension patients