尿海藻糖酶检测在近端肾小管损害诊断中的临床价值  

Evaluation urinary trehalase in patients with renal proximal tubular damage

作　　者：韩晓芳 谭艳 贾海琴 侯魏 王晶 王虹 刘瑞平 白瑞霞 

机构地区：[1]内蒙古自治区人民医院检验科,呼和浩特010017

出　　处：《中华检验医学杂志》2012年第12期1135-1138,共4页Chinese Journal of Laboratory Medicine

基　　金：内蒙古自治区自然科学基金资助项目（200308020618）

摘　　要：目的探讨尿海藻糖酶（T）在近端肾小管损害中的价值。方法采用实验室指标对照研究，选取2005--2011年在内蒙古自治区人民医院就诊，确诊为肾脏疾病患者134例（男66例，女68例，年龄18—59岁）（急性肾功能衰竭31例、慢性肾功能衰竭30例、药物性肾损害20例、肾移植术后21例、肾病综合征32例）和101名健康对照者（男58名，女43名，年龄18～56岁）进行尿T及尿N-乙酰-β-D氨基葡萄糖苷酶（NAG）、r-谷氨酰转酞酶（GGT）、β2-微球蛋白（β2-MG）4项指标检测，建立受试者工作特征曲线（ROC）评价系统，比较尿T在近端肾小管损害中的价值。实验数据采用SPSS11．5统计软件进行非参数秩和检验、ROC曲线分析。结果101名健康对照者尿T结果近似正态分布（Z=1．09，P=0．183），结果为（7．14-4．1）μmol／h·g Cr（0～25μmol／h·gCr）男女间差异无统计学意义（t=0．63，P〉0．05）；肾脏疾病各组尿T水平与对照组比较差异有统计学意义（Z=6．80、5．90、5．23、6．00、8．04，P均〈0．01）。ROC曲线分析结果显示，134例患者尿T的ROC曲线下面积为0．9，与NAG、β2-MG、GGT曲线下面积比较差异有统计学意义（P均〈0．01）；分组研究结果显示：4项检测指标在急性肾功能衰竭、慢性肾功能衰竭、药物性肾损害、肾移植术后、肾病综合征组中以尿T的ROC曲线下面积最大（0．94、0．85、0．90、0．90、0．91）；尿T约登指数分别为0．85、0．65、0．77、0．66、0．72，其对应的诊断敏感度、特异度分别为90．3％、95．1％；73．3％、92．1％；85．0％、92．1％；81．0％、85．2％；87．5％、84．2％。结论尿T在反映近端肾小管损害的诊断价值优于其他指标，能更好地对近端肾小管功能进行早期判断，对肾脏疾病诊治及预后估计具有重要意义。f手华检验医学杂，士，2012，35：1135—1138）Objective To investigate the value of urinary trehalase （T） in patients with renal proximal tubular damage. Methods 134 patients with kidney disease （male：66 female ：68 age：18 -59; 31 cases with acute renal failure, 30 cases with chronic renal failure, 20 cases with drug-induced renal impairment, 21 cases with renal transplantation and 32 cases with nephritic syndrome ） and 101 healthy controls （58 males and 43 females） were selected. Urinary T, N-acetyl-D-glucosaminidase （NAG）, β2- MG, gamma-glutamyl transferase （GGT） were detected. Data were analyzed by SPSS 11.5, including non- parametric rank test, ROC analysis. Results The level of urinary trehalase in control group was normally distributed （ 7. 1 ± 4. 1 ） p.mol/h g Cr （ 0 - 25 μmol/h· g Cr ） . There was no significant difference between men and women （ t = 0. 63, P = 0. 53 ）. Urinary T levels were significant higher in all kidney disease groups than in control group （Z =6. 80,5.90, 5.23, 6. 00, 8.04,P 〈0. 01）. According to ROC curve, the area of urinary T under the ROC curve （AUC） in 134 patients was 0. 9, significantly different with NAG, β2-MG, GGT area （P 〈0. 01 ） ,the AUCs of T were 0. 94,0. 85, 0. 90,0. 90,0. 91 in acute and chronic renal failure group, drug-induced renal impairment group, renal transplantation group and nephritic syndrome group, respectively ; Youden index were 0. 85,0. 65,0. 77,0. 66,0. 72 respectively. Corresponding to the Youden index,sensitivity and specificity were 90. 3% and 95.1%, 73.3% and 92. 1%, 85.0% and 92. 1% , 81.0% and 85.2% , 87.5% and 84. 2% respectively. Conclusions The Urinary trehalase is better than other markers in the diagnosis of the proximal renal tubular damage. It was better to evaluate the proximal tubular function early in time. The diagnostic value of urinary trehalase played a key role in diagnosis, treatment and prognosis of kidney diseases.

关 键 词：肾疾病 肾小管 近端 海藻糖酶 尿分析 

分 类 号：R692[医药卫生—泌尿科学]