尿游离轻链测定对原发性高血压早期肾损害的诊断价值  

Diagnostic value of urine free light chain in early phage of essential hypertension

作　　者：叶松道[1] 陈晓晴[1] 温怀凯[1] 

机构地区：[1]温州医学院附属第二医院检验科,325027

出　　处：《浙江医学》2005年第11期803-804,874,共3页Zhejiang Medical Journal

摘　　要：目的探讨尿游离轻链测定对原发性高血压(EH)患者早期肾脏损害诊断的敏感性。方法以速率散射比浊法测定76例EH患者和35名健康体检者尿液中游离轻链(κ、λ)和α1微球蛋白(α1-MG)水平,并对检测结果进行统计学分析。结果EH组患者尿游离轻链κ(59.6±23.5)mgL、λ(31.2±16.2)mgL和α1-MG(13.5±3.0)mgL均明显高于对照组(28.7±15.2)mgL、(15.1±11.3)mgL、(4.4±2.3)mgL(t=2.841、2.786、3.161,均P<0.01);EH组患者游离轻链κ、λ、α1-MG阳性率分别为21.1%、19.7%和23.7%,对照组κ、λ、α1-MG阳性率均为0,两组比较差异有显著性意义(χ2=8.61、6.39、9.89,均P<0.05);EH组患者κλ(1.91±0.52)与对照组(1.90±0.45)比较差异无显著性意义(t=1.332,P>0.05);随着病程的增加,EH患者尿游离轻链κ、λ和α1-MG水平不断升高(F=15.57、12.67、32.45,均P<0.01);EH患者尿游离轻链κ、λ与α1-MG呈显著正相关(r=0.893、0.889,均P<0.01)。结论尿游离轻链κ、λ测定对早期发现EH肾损害有重要意义,可作为EH患者肾损害的早期监测指标。Objective To access the clinical significance of renal damage on change of urine free light chain in patients with essential hypertension（EH）. Methods Urine free light chain（ κ , λ） and α1-microglobulin（α1- MG） were determined with rate nepherometry in 35 healthy persons and 73 patients with EH. Results The levels of κ, λ and α1-MG in patients with EH were significantly higher than that in healthy persons（P〈0.01）, and the possive rate of them in EH group are 21.1%,19.7% and 23.7% respectively. The κ and λ light chain increased simultaneously in the majority of patients with EH,but the κ/λ ratio was normal（P〉0.05）. The possive rates and levels of κ , λ and α1-MG are becoming higher continuously,as disease progressing of EH patients. A significant possive correction was noted between urine free light chain and α1-MG in patients with EH （P〈0.01）,and the diagnostic result of them were no significant difference （P〉0.5）. Conclusion Detection of urine free light chain is of great importance for discovering and monitoring renal injury in patients with EH.

关 键 词：原发性高血压 肾脏损害 尿游离轻链 Α1微球蛋白 

分 类 号：R544.1[医药卫生—心血管疾病] R446.62[医药卫生—内科学]