α_1-微球蛋白在急性有机磷农药中毒患儿肾损害早期诊断中的意义  

Significance of α_1-Microgbulin in Early Diagnosis of Renal Damage Induced by Acute Organophosphorus Pesticide Poisoning in Children

作　　者：陈鹏年[1] 夏成云[2] 雷静[3] 蒲忠斌 

机构地区：[1]达州市第二人民医院儿内科,四川达州635000 [2]川北医学院附属医院肾内科,四川南充637000 [3]川北医学院附属医院肿瘤科,四川南充637000 [4]渠县人民医院肾内科,四川渠县635200

出　　处：《实用儿科临床杂志》2010年第18期1389-1390,共2页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨α1-微球蛋白(α1-MG)在急性有机磷农药中毒(AOPP)患儿肾损害早期诊断中的价值。方法根据AOPP分级诊断标准将85例AOPP患儿分成3组:轻度中毒组(21例)、中度中毒组(31例)、重度中毒组(33例);另取30例健康儿童作为健康对照组。各组儿童均行血、尿α1-MG,血尿素氮(BUN)、血肌酐(Cr)测定,并进行对比分析。α1-MG水平采用免疫散射比浊法在Beckman Array 360特种蛋白分析仪上进行测定,BUN、Cr采用Beckman CX 7全自动生化分析仪测定。结果 AOPP轻度中毒组患儿血α1-MG和尿α1-MG较健康对照组显著升高(Pa<0.05),而血BUN、Cr与健康对照组比较差异无统计学意义(Pa>0.05);中度中毒组和重度中毒组血α1-MG、尿α1-MG及血BUN、Cr与健康对照组比较,均显著升高(Pa<0.01);中度中毒组和重度中毒组血α1-MG、尿α1-MG及血BUN、Cr与轻度中毒组比较,均显著升高(Pa<0.05,0.01);重度中毒组血α1-MG、尿α1-MG及血BUN、Cr与中度中毒组比较均显著升高(Pa<0.05)。结论 1.血α1-MG、尿α1-MG可作为AOPP患儿肾损害早期诊断的敏感指标,且比血BUN、Cr更敏感,这对判断AOPP患儿肾功能损害的发生、发展,防止肾衰竭的发生具有重要意义。2.在一定程度上α1-MG水平高低可反映AOPP患儿中毒程度,对AOPP病情轻重及预后的判断有一定临床价值。Objective To explore the value of α1-microgbulin（α1-MG）in the early diagnosis of toxic renal damage induced by acute organophosphorus pesticide poisoning（AOPP） in children.Methods Eighty-five AOPP children were divided into 3 groups according to the classification criteria for diagnosis of AOPP ：light poisoning（LP）group（21 cases）,moderate poisoning（MP）group（31 cases） and severe poisoning（HP）group（33 cases）;30 healthy children were collected as healthy control group.The α1-MG in blood and urine,blood urea nitrogen（BUN）,serum creatinine（Cr） of all the objects were determined.α1-MG content was detected by immunonephelometry in Beckman Array 360 immuno analyzer,BUN and Cr were detected by Beckman CX 7 automatic biochemistry analyzer.Results Blood α1-MG and urine α1-MG in LP group were obviously higher than those in the healthy control group（Pa〈0.05）,BUN and Cr had no significant differences compared with those in the healthy control group（Pa〉0.05）.In MP group and HP group,the blood α1-MG,urine α1-MG,BUN and Cr increased obviously compared with those in the healthy control group（P〈0.01）.In MP group and HP group,the blood α1-MG,urine α1-MG,BUN and Cr,increased obviously compared with those in LP group（Pa〈0.05,0.01）.And in HP group,the blood α1-MG,urine α1-MG,BUN and Cr,increased obviously compared with those in MP group（Pa〈0.05）.Conclusions 1.Blood α1-MG and urine α1-MG may be a sensitive index in the early diagnosis of toxic renal damage induced by AOPP in children,and they are more sensitive than BUN and blood Cr.2.The level of blood and urine α1-MG have certain clinical value and can be the index of the severity and prognosis of AOPP.

关 键 词：中毒 有机磷农药 Α1-微球蛋白 肾损害 

分 类 号：R725.9[医药卫生—儿科]