βTP与KIM-1检测对高血压患者早期肾损伤诊断价值的研究  

Diagnostic Value of Serum β Trace Protein and Urine Kidney Injury Molecule-1 for Early Signs of Kidney Damage in Patients with Hypertension

作　　者：李宁 曹雷 柴成国 吴妍 吴风春 

机构地区：[1]河北省衡水市人民医院,河北衡水053000

出　　处：《标记免疫分析与临床》2016年第7期757-759,793,共4页Labeled Immunoassays and Clinical Medicine

基　　金：2014年度衡水市科学技术研究与发展计划(编号:14008A)

摘　　要：目的探讨血清β痕迹蛋白(βTP)与尿肾损伤分子-1(K1M-1)对高血压患者早期肾损伤的诊断价值。方法选择衡水市人民医院住院治疗的高血压患者194例作为观察组(符合2013年卫生部心血管病防治研究中心制定的《中国高血压防治指南》(修订版)的诊断标准),清晨采集病人空腹静脉血,用胶乳增强散射免疫比浊法测定其血清βTP的含量,酶法测定血肌酐(Scr)的含量;同时收集病人晨尿,采用定量酶联免疫吸附试验测定尿KIM-1,免疫比浊法测定尿微量清蛋白(UALB)的含量,比色法测定尿N-乙酰-β—D-氨基葡糖糖苷酶(NAG)的含量。按照UALB的浓度分为三组:UALB正常组(63例),少量UALB组(71例)和大量UALB组(60例);另外选取60例肾功能及血压均正常的健康体检者作为对照组,标本采集及指标测定方法同观察组。结果观察组三组中的血βTP与尿KIM-1水平均显著高于对照组(P<0.05)。血βTP、尿KIM-1及Scr在三组中的阳性率分别为:30.2%,66.2%,90.0%;33.3%,64.8%,86.7%;0.0%,15.5%,45.0%。三组中血βTP与尿KIM-1阳性率均显著高于Scr(P<0.05)。血βTP与尿KIM-1与Scr、NAG、GFR以及病程做相关分析表明,两者与Scr呈正相关(r分别为0.637、0.621,P均<0.05);与尿NAG浓度成正相关(r分别为0.661、0.794,P均<0.05),与病程呈正相关(r分别为0.694、0.707,P均<0.05);与GFR呈负相关(r分别为-0.691、-0.667,P均<0.05)。结论血βTP与尿KIM—1均是高血压患者早期肾损伤敏感而可靠的诊断指标,血βTP可以早期反映其肾小球滤过功能,尿KIM-1可以作为评价其肾小管早期损伤的有效指标。Objective To investigate the diagnostic value of serum β trace protein （βTP） and urine kidney injury molecule-1（KIM-1）for early renal damage in patients with hypertension. Methods 194 cases of patients with hypertension and 60 healthy people were involved in this study. The serum levels of β-TP and creatinine （Scr） were detected by LaTeX enhanced scattering immunoturbidimetric assay and enzyme assay. The urinary KIM-1, UALB and NAG levels were determined by using quantitative enzyme-linked immunosorbent assay, immunoturbidimetric and colorimetric determination method respectively. According to the amount of urinary UALB, the patients were divided into UALB normal group （63 cases）, small amount UALB group （71 cases） and large UALB group （60 cases）. Results The level of serum βTP and urine KIM-1 in patients with hypertension were significantly higher than that of controls （P〈0.05）. The positive rate of serum βTP, urine KIM-1 and serum Scr in UALB normal group, small amount UALB group and large UALB group were 30.2%, 66.2%, 90.0%; 33.3%, 64.8%, 86.7% and 0.0%, 15.5%, 45.0% respectively. The positive rates of serum βTP and urine KIM-1 in three groups were all significantly higher than that of serum Scr （P〈0.05）. The serum βTP and urine KIM-1 were positively correlated with serum Scr, urine NAG and disease course （P〈0.05）, was negatively correlated with GFR （P〈0.05）. Conclusion Serum βTP and urine KIM-1 might be the sensitive and reliable diagnostic indicator for early renal damage in patients with hypertension. The serum βTP can reflect early glomerular filtration function, and urine KIM-1 can be used as effective index for renal tubular damage evaluation.

关 键 词：血清β痕迹蛋白 肾损伤分子-1 早期肾损伤 血肌酐 肾小球滤过率 

分 类 号：R544.1[医药卫生—心血管疾病]