检测尿中四种微量蛋白对早期高血压性肾损害的临床意义探讨

The discussion of the clinic signification of detecting four minum proteins in urine of the hypertensive injury of kidney patients

目的 检测原发性高血压病人尿中的尿微量白蛋白 (MA )、α1 -微球蛋白 (A1 M)、尿免疫球蛋白(Ig U)和尿转铁蛋白 (TRU) ,观察高血压性肾损害早期尿中微量蛋白变化 ,探讨其临床意义。方法 采用速率散射比浊法 ,测定 70例原发性高血压病人和 4 0例健康人尿中的 MA、 A1 M、 Ig U、 TRU。结果 有高血压家族史 (FH+)组中 , 期组四种蛋白与对照组比无显著差异 (P>0 .0 5 ) ;无高血压家族史 (FH- )组中 , 期组 MA、A1 M与对照组比有显著差异 (P<0 .0 5 ) ;TRU、 IGU与对照组比无显著差异 (P>0 .0 5 )。 FH+组与 FH-组 , 期 MA、TRU、A1 M与对照组比有显著差异 (P<0 .0 5 ) ,IGU与对照组比无显著差异 (P>0 .0 5 ) , 期组四种蛋白与对照组比均有显著差异 (P<0 .0 5 ) ,同期 FH +组与 FH-组比较无显著差异 (P>0 .0 5 )。四种蛋白与高血压病病程成正相关 , 、 期升高较平缓 , 期明显升高 ,尤其是 MA升高更显著。结论 MA、A1 M、 TRU、IGU是诊断早期高血压性肾损害的敏感指标 ,其中以 MA最敏感 ,然后依次为 A1 M、 TRU、 IGU。

Objective To study the clinical signification of micro protein(MA),α1 microprotein(A1M),immunoglobulin(IgU)and transferrin(TRU)in urine in initial stage of hypertensive renal injury patients.Methods MA,A1M,IgU,and TRU in urine from 70 primary hypertensive patients and 40 controls were measured by using scatting rate of speed comparing turbidity.Results In family history hypertension(FH+)group,the four kinds of urine proteins in stage 1 group were not significantly different from those in controls( P >0 05).In no family history hypertension(FH-)group,MA and A1M in stage 1 group were significantly different from those in controls( P <0 05),TRU and IgU was not significantly different from those in contrals( P >0 05);In FH+and FH- groups,MA,TRU and A1M in stage 2 group were distinguish from those in controls( P <0 05);all four kinds of proteins in stage 3 group were significantly different from those in controls( P <0 05).there were no differences between FH+ group and FH- group in the same stage( P >0 05).Conclusion MA,A1M,TRU and TgU are sensitive index in diagnose the initial renel injury in hypertensive patients,and the most sensitive index is MA.Its useful for staging the hypertension and predicting the degree of hypertensive renel injury.