血尿联合检测在急性有机磷农药中毒肾脏损害早期诊断中的价值  

Blood and urine tests for early diagnosis of kidney injury in patients with acute organophosphorus pesticide poisoning

作　　者：柯颖杰[1] 张萍[1] 陈江华[1] 

机构地区：[1]浙江大学医学院附属第一医院肾脏病中心,杭州310003

出　　处：《浙江医学》2013年第4期271-273,共3页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划（2011RCB020）

摘　　要：目的探讨血尿联合检测在急性有机磷农药中毒（AOPP）肾脏损害早期诊断中的价值。方法选取并发肾损害的63例AOPP患者，其中轻度中毒12例（轻度组），中重度中毒51例（中重度组）。另择同期体检健康者30例作为对照组。检测比较3组对象血胱氨酸蛋白酶抑制剂C（CysC）、Scr、血清胆碱酯酶（chE）及尿微量白蛋白（mAIb）、a1-微球蛋白（al—MG）、N-乙酰-B—D氨基葡萄糖苷酶（NAG）含量，并分析血尿指标的相关性。结果63例AOPP患者中60岁以上者明显多于21—40、41-60岁者（P〈0．05）。与对照组比较。轻度组及中重度组血清chE活力明显下降（P〈0．05或0．01），血Scr、CysC及尿mAIb、al—MG、NAG明显升高（P〈0、05或0．01）；与轻度组比较，中重度组血清chE活力显著下降（P〈0．01），血Scr、CysC及尿mAIb、al—MG、NAG均显著升高（均P〈0．01）。尿mAIb、al—MG、NAG含量均与血清chE活力呈负明显相关（r=-023、-0．48、-0．43，P〈0．05或0．01）。结论AOPP的严重程度与肾功能损害的严重程度-致，易发生于老年患者，血CysC及尿mAIb、al—MG、NAG的变化与肾脏损害的严重程度也是-致的，血尿联合检测有助于AOPP早期肾损害的诊断。Objective To assess the blood and urine tests for early diagnosis of kidney injury in patients with acute organophosphorus pesticide poisoning （AQPP）. Methods Sixty three patients with AOPP were enrolled in the study, including 12 cases of low-grade poisoning （mild group） and 51 cases of mid-severe poisoning （mid-severe group）. Thirty healthy sub- jects were used as control group. The serum cystatin C （CysC）, creatinine （Scr）, cholinesterase（chE）and urinary microalbumin （mAIb）, al-microglobulin （al-MG）, N-acetyl-15-d-glucosaminidase （NAG） levels were tested and compared among three groups. Results Serum chE levels in two groups of AOPP patients were significantly lower than those in control group （P〈0.05 or 0.01）; serum Scr, CysC and urinary mAIb, al-MG, NAG were significantly higher than those in control group （P〈0.05 or 0.01）. Serum chE levels in mid-severe AOPP patients were significantly lower, and serum Scr, CysC and urinary mAIb, al-MG, NAG were significantly higher than those in mild group （aLl P〈0.01）. Urinary mAIb, al-MG and NAG levels were negatively correlated with serum chE levels （r=-0.23, -0.48 and -0.43,respectively, P〈0.05 or 0.01 ）. Conclusion The severity of AOPP is correlated with kidney injury. Serum cysc and urinary mAIb, al-MG, NAG level are correlated with the severity of kidney injury in AOPP patients, indicating that blood and urine tests can be used as early indicators of kidney injury in AOPP patients.

关 键 词：急性有机磷农药中毒 肾损伤 血尿联合检测 

分 类 号：R595.4[医药卫生—内科学]