氨甲酰血红蛋白测定在急慢性肾功能衰竭诊断中的价值  

Differentiation of acute from chronic renal failure by detection of carbamylated hemoglobin

作　　者：王美雯[1] 梅长林[2] 缪海钧[2] 朱才娟[2] 

机构地区：[1]上海市黄浦区中心医院,200003 [2]第二军医大学长征医院

出　　处：《上海医学》1999年第10期609-611,共3页Shanghai Medical Journal

摘　　要：目的　探讨氨甲酰血红蛋白（ Ｃａｒ Ｈｂ） 在急、慢性肾衰中的诊断价值。方法　用高效液相色谱法测定健康对照组３６ 例，急性肾衰１０ 例，慢性肾衰５１ 例患者 Ｃａｒ Ｈｂ 含量。按肾衰程度将慢性肾衰（ Ｃ Ｒ Ｆ） 分为轻度、中度和重度３ 个亚组，将３ 组 Ｃａｒ Ｈｂ 含量与 Ｂ Ｕ Ｎ、 Ｓｃｒ 作相关性分析。结果　与对照组 Ｃａｒ Ｈｂ 含量［（３０ ．０ ±６ ．１）μｇ Ｃ Ｖ／ｇ Ｈｂ］ 比较，急性肾衰组 Ｃａｒ Ｈｂ 含量显著升高，但显著低于慢性肾衰组［（６７ ．４ ±２３ ．２） 和（１３９ ．９ ±５２ ．０）μｇ Ｃ Ｖ／ｇ Ｈｂ ， Ｐ＜ ０ ．０１］ 。急性肾衰组 Ｃａｒ Ｈｂ 与 Ｂ Ｕ Ｎ、 Ｓｃｒ 相关不显著；所有急性肾衰病例 Ｃａｒ Ｈｂ 均≤１０５ ．０μｇ Ｃ Ｖ／ｇ Ｈｂ ， Ｃａｒ Ｈｂ／ Ｂ Ｕ Ｎ≤３ ．５ ， Ｃａｒ Ｈｂ／ Ｓｃｒ ≤０ ．１５ 。慢性肾衰组 Ｃａｒ Ｈｂ 与 Ｂ Ｕ Ｎ 及 Ｓｃｒ 成正比。结论　测定 Ｃａｒ Ｈｂ 是鉴别急慢性肾衰的有用指标，并能反映慢性肾衰程度。Objective To assess the diagnostic value of carbamylated hemoglobin( Car Hb) in diffe rentiation between patients with acute( A R F) and chronic renal failure( C R F) . Methods Car Hb wasprospectively measured in 36 normalsubjects,10 A R Fand 51 C R Fby high performance liquid chromato graphy( H P L C) , Car Hb concentration was expressed as μg of carbamyl valine per gram of hemoglobin(μg C V/g Hb) .51 C R Fsubjects were classified asthree subgroups , mild , moderate and severe according tothe severity of renalfailure,the correlation of Car Hb was analyzed with B U N and Scrin C R F. Results Compared with normalcontrols(30 .0 ±6 .1μg C V/g Hb) , Car Hb in A R F was significantly increased ,but Car Hbin A R F was remarkably lower than that in C R F(67 .4 ±23 .2μg C V/g Hb vs 139 .9 ±52 .0μg C V/g Hb , P< 0 .01) and Car Hb in A R F was not significantly correlated with B U Nand Scr . All patients with A R Fhad a Car Hb concentration below 105 .5μg C V/g Hb ,the ratio of Car Hb to B U N was less than 3 .5and the ratio of Car Hb to Scr was less than 0 .15 . Car Hb in 3 C R Fgroups was positively correlated with B U Nand Scr . Conclusions Measurement of Car Hb is usefulin differentiating A R Ffrom C R Fpatients,itcan also reflect the severity of C R F.( Shanghai Med J,1999 ,22 :609 611)

关 键 词：氨甲酰血红蛋白 肾功能衰竭 诊断 

分 类 号：R692.504[医药卫生—泌尿科学]