肾结石患者PCNL术前尿蛋白定性与术后早期肾损伤的相关性研究  

A study on relationship between preoperative urinary protein and early renal injury in patients with renal calculi after PCNL

作　　者：魏娜 何文强 孟珊珊 王倩 路一平 WEI Na;HE Wen-qiang;MENG Shan-shan;WANG Qian;LU Yi-ping(Armed Police Corps Hospital of Henan,Zhengzhou 450052,China)

机构地区：[1]武警河南省总队医院,郑州450052

出　　处：《医药论坛杂志》2018年第9期33-34,38,共3页Journal of Medical Forum

摘　　要：目的尿蛋白是肾功能受损的重要指标,评价肾结石患者术前尿蛋白阳性对其PCNL术后肾功能早期受损的判断价值。方法对武警河南省总队医院96例肾结石患者采用PCNL治疗,监测术前尿蛋白、肾功能指标(Cr、Bun、GFR),及术后尿蛋白、尿微量蛋白(α1-MG、NAG、β2-MG、TRF、Um A1b、Ig G)和肾功能指标,对检测数据和各指标阳性率进行统计分析。结果肾结石患者术前尿蛋白阳性与术后血清Cr、Bun无相关(P> 0. 05),但是,随着尿蛋白的增加,术后GFR有下降趋势(P <0. 05)。术后TRF、Um A1b和Ig G阳性率高于α1-MG、NAG和β2-MG的阳性率,差异有统计学意义(P <0. 05)。结论术前中、重度蛋白尿肾结石患者术后肾功能受损更显著,适合诊断肾结石患者术后早期肾功能损伤程度。肾结石患者行PCNL术对肾小球功能损害高于肾小管功能损伤。Objective Urine protein is an important index of renal function impairment,and the value of preoperative urinary protein positive is evaluated to detect the early damage of renal function in patients with renal calculi after PCNL operation. Methods Totally 96 patients with renal calculi were treated by PCNL,testing urinary protein,renal function indexes（ Bun,Cr,GFR） before operation urine protein,urine microalbumin excretion（ α1-MG,NAG,β2-MG,TRF,Um A1 b,Ig G）,renal function indexes after operation,the statistical analysis of the test data and the positive rate of each index was performed. Results There was no correlation between urinary protein positive and serum Cr and Bun in patients with kidney stones（ P〉0. 05）. However,with the increase of urine protein,GFR had a tendency to decrease（ P〈0. 05）. The positive rate of Ig G,Um A1 b and TRF was higher than that of 1-MG,NAG and 2-MG,and the difference was statistically significant（ P〈0. 05）. Conclusion The renal function of renal calculi patients with severe proteinuria is much more damaged,and it is suitable for the diagnosis of early renal damage after operation. Glomerular damage was higher than that of renal tubular injury in PCNL operation of patients with renal calculi.

关 键 词：尿蛋白 尿微量蛋白 肾结石 经皮肾镜取石术 

分 类 号：R692.4[医药卫生—泌尿科学]