肝炎肝硬化患者肾功能分析39例  

Clinical research on renal injury in patients with cirrhosis and hepatitis:an analysis of 39 cases

作　　者：蔺武[1] 刘心娟[1] 常岩芹[1] 王莉[1] 林香春[1] 

机构地区：[1]北京世纪坛医院消化内科,北京市100038

出　　处：《世界华人消化杂志》2007年第35期3749-3751,共3页World Chinese Journal of Digestology

摘　　要：目的:探讨肝炎肝硬化患者的肾功能损害方法:检测39例不同分期肝硬化患者(肝硬化组,肝功能Child A,B,C级分别为15例,12例,12例)和20例体检正常者(对照组)的肌酐清除率(Ccr)、尿微量白蛋白(UmALB)、尿α1-MG(Uα1-MG)、尿β2-MG(Uβ2-MG)、尿NAG酶(NAG-U)、尿转铁蛋白(TRF-U)和尿视黄醇结合蛋白(RBP)的活性.结果:Child C组的Ccr低于对照组和Child A,B组(51.54±25.79 vs 105.41±13.75,95.61±23.09,89.16±18.19,P<0.05),而后3组间没有差别.Child B、C组UmALB高于对照组和Child A组(42.53±19.12,108.07±41.64 vs 14.10±3.26,13.11±2.72,P<0.05);ChildA,B组的Uα1-MG、Uβ2-MG、NAG-U、RBP与对照组无差别,而Child C组对应指标高于对照组和Child A,B组(26.95±35.34 vs 6.81±1.88,6.87±2.10.5.66±0.81;747.78±596.72 vs 108.85±65.86,115.00±73.83,147.25±91.55;32.30±16.91 vs 15.68±3.14,17.13±5.35,18.90±10.23;281.98±133.19 vs 119.63±25.94,124.39±34.90,168.25±11.76;P<0.05).肝硬化Child A.B.C组的TRF-U与对照组比较均有显著性差异(6.54±2.28,7.59±3.21,8.04±5.64 vs 0.47±0.21,P<0.05),肝硬化3组间无差别.结论:UmALB、Uα1-MG、Uβ2-MG和NAG活性的测定有助于早期发现肝炎肝硬化患者的肾功能损害,TRF-U和RBP不适合作为肝硬化患者早期肾功能损害的研究指标.AIM： To study the renal injury in patients with cirrhosis and viral hepatitis. METHODS： Twenty nine patients with cirrhosis and viral hepatitis and 20 normal control subjects were selected. Ccr, UmALB, Uα1-MG, Uβ2-MG, NAG-U, TRF-U and RBP levels were measured. RESULTS： The levels of Ccr were lower in Child C patients than in Child A, Child B and control patients （51.54 ± 25.79 vs 105.41 ± 13.75, 95.61 ± 23.09, 89.16 ± 18,19, P 〈 0.05）. The levels of UmALB were higher in Child B and Child C patients than in control and Child A patients （42.53 ± 19.12, 108.07 ± 41.64 vs 14.10 ± 3.26, 13.11 ± 2.72, P 〈 0.05）. The levels of Uα1-MG, Uβ2-MG, NAG-U, RBP were higher in Child C patients than in the control group and Child A and B patients （26.95 ± 35.34 vs 6.81 ± 1.88, 6.87 ± 2.10, 5.66 ± 0.81; 747.78 ± 596,72 vs 108.85 ±_ 65.86, 115.00 ± 73.83, 147.25 ± 91.55; 32.30 ± 16.91 vs 15.68 ± 3.14, 17.13 ± 5.35, 18.90 ± 10.23; 281.98 ± 133.19 vs 119.63 ± 25,94, 124.39 ± 34.90, 168.25 ± 11.76; P 〈 0.05）. The levels of TRF-U were higher in all patients than in controls （6.54 ± 2.28, 7.59 ±3.21, 8.04 ± 5.64 vs 0.47 ± 0.21, P 〈 0.05）. CONCLUSION： UmALB, Uα1-MG, Uβ2-MG and NAG-U are sensitive and useful items for the diagnosis of early renal injury in patients with cirrhosis and type B viral hepatitis, but TRF-U and RBP are not.

关 键 词：肝硬化 肾功能损害 肝炎 

分 类 号：R575.2[医药卫生—消化系统]