肾小管损伤标志物检测对慢性肾脏病高危人群的意义及影响因素研究  

Study on the significance and influencing factors of detection of renal tubular injury markers in high-risk patients with chronic renal disease

作　　者：刘辉[1] 孙懿[1] 姚英[1] LIU Hui;SUN Yi;YAO Ying(Department of Nephrology, Fuxing Hospital Affiliated to Capital Medical University, Beijing 100038, China)

机构地区：[1]首都医科大学附属复兴医院肾内科

出　　处：《临床肾脏病杂志》2019年第9期672-676,共5页Journal Of Clinical Nephrology

摘　　要：目的探讨肾小管损伤标志物检测在慢性肾脏病(CKD)高危人群早期发现中的意义,分析肾小管损伤标志物异常升高的影响因素。方法纳入CKD高危人群266例,记录患者一般临床资料、血生化指标、尿微量白蛋白肌酐比值(urine microalbumin creatinine ratio,ACR)、肾小管损伤指标[包括尿β2-微球蛋白(Beta2-Microglobulin,β2-MG)、尿α1-微球蛋白(Alpha1-microglobulin,α1-MG)、尿视黄醇结合蛋白(retinol binding protein,RBP)]。依据尿ACR分为阳性组与阴性组,分析肾小管损伤标志物检测的早期意义及肾小管损伤标志物的相关影响因素。结果尿ACR阳性组肾小管损伤的阳性率为86.36%,高于尿ACR阴性组,但在尿ACR阴性患者有48.72%的患者出现了肾小管损伤标志物的异常升高;尿ACR阳性组患者的肾小管损伤标志物的损伤水平、异常项数均明显高于阴性组,差异具有统计学意义(P<0.05)。肾小管标志物阳性组患者的年龄显著高于阴性组,差异有统计学意义(P<0.05);多元逐步回归分析提示血尿酸(OR=0.992,P=0.009)是肾小管损伤标志物异常升高的相关因素。结论肾小管损伤标志物检测对于发现早期肾损伤具有较高的临床价值。Objective To explore the significance of early detection of renal tubular markers in the high risk population with chronic kidney diseases (CKD), and analyze the influencing factors of abnormal increase of renal tubular injury markers. Methods According to the inclusion and exclusion criteria, 266 subjects were included in the study. The general clinical data, biochemical blood parameters, urine microalbumin-creatinine ratio(ACR), renal tubular injury indices[including Beta2-Microglobulin(β2-MG), Alpha1-microglobulin(α1-MG), Retinol Binding Protein (RBP)] were recorded. The subjects were divided into positive and negative groups based on urinary ACR. The significance of early detection of renal tubular injury markers and the related influencing factors were analyzed. Results The positive rate of renal tubular injury in the urine ACR positive group was 86.36%, higher than that in the urine ACR negative group. However, in the urine ACR negative, 48.72% of patients had abnormal increase of renal tubular injury markers. Abnormal amplitude and abnormal item number of renal tubular injury markers in the urine ACR positive group were significantly higher than those in the negative group, with statistically significant difference (P<0.05). The ages of patients in the positive group were significantly higher than that in the negative group, with statistically significant difference (P<0.05). Multivariate stepwise regression analysis suggested that blood uric acid (OR=0.992, P=0.009) was a correlative factor for abnormal increase of renal tubular injury markers. Conclusions The detection of renal tubular protein has high clinical application value for the detection of early renal injury.

关 键 词：尿微量白蛋白 肾小管损伤标志物 慢性肾脏病 

分 类 号：R692[医药卫生—泌尿科学]