尿生化指标在慢性肾病分期中的诊断价值  

Diagnostic value of urinary biochemical indexes detection in diagnosis of chronic kidney diseases staging

作　　者：马媛媛[1] 穆红光 王晓寅[1] 李凡 陈珊[1] MA Yuanyuan;MU Hongguang;WANG Xiaoyin(The Second Hospital Affiliated to Hebei North College,Hebei,Zhangjiakou 075100,China)

机构地区：[1]河北北方学院附属第二医院,河北省张家口市075100 [2]张家口宣钢医院

出　　处：《河北医药》2020年第14期2117-2120,共4页Hebei Medical Journal

基　　金：张家口市科学技术研究与发展计划(编号:1821034D)。

摘　　要：目的探讨尿生化指标在慢性肾病(CKD)分期中的诊断价值。方法选取2016年1月至2019年10月收治的CKD患者234例为研究对象,根据肾小球滤过率(GFR)分为CKD G1期组(n=58)、CKD G2期组(n=50)、CKD G3期组(n=52)、CKD G4期组(n=44)、CKD G5期组(n=30),另设同期健康体检者30例为对照组。比较6组血清肌酐(SCr)、尿素氮(BUN)、24 h尿蛋白(24 h Up)、尿白蛋白/尿肌酐比值(ACR)及4项尿微量蛋白[尿微量白蛋白(UmAlb)、β2微球蛋白(Uβ2MG)、转铁蛋白(UTRF)、免疫球蛋白(UIgG)]水平,并分析UmAlb、Uβ2MG、UTRF、UIgG与GFR及各指标间的相关性。结果CKD G1期组GFR、血清SCr、BUN、UmAlb、Uβ2MG、UTRF、UIgG与对照组比较差异无统计学意义(P>0.05);随着CKD分期进展,G2~G5期组GFR较对照组显著降低,UmAlb、Uβ2MG、UTRF、UIgG较对照组显著升高,差异有统计学意义(P<0.05);G3~G5期组血清SCr、BUN较对照组显著升高,差异有统计学意义(P<0.05);G1~G5期组24 h Up、ACR较对照组显著升高,差异有统计学意义(P<0.05)。Spearman相关分析显示,UmAlb、Uβ2MG、UTRF、UIgG与GFR均呈负相关(r=-0.724、0.798、0.702、0.736,P<0.05);UmAlb与Uβ2MG、UTRF、UIgG均呈正相关(r=0.749、0.713、0.646,P<0.05),Uβ2MG与UTRF、UIgG均呈正相关(r=0.604、0.684,P<0.05),UTRF与UIgG呈正相关(r=0.661,P<0.05)。结论随着CKD分期进展,尿微量蛋白逐渐升高,对疾病早期诊断、病情和预后评估具有重要价值。Objective To investigate the application value of urinary biochemical indexes detection in diagnosis of chronic kidney diseases(CKD)staging.Methods A total of 234 patients with CKD,who were admitted and treated in our hospital from Jan 2016 to Oct 2019,were divided into five groups according to glomerular filtration rate(GFR):phase G1group(n=58),phase G2 group(n=50),phase G3group(n=52),phase G4 group(n=44)and phase G5group(n=30).Another 30 healthy cases were taken as controls.The levels of Serum SCr,BUN,24h urine protein(24 h Up),urinary albumin to creatinine ratio(ACR)and four urinary trace proteins[urine microalbumin(UmAlb),urine beta 2microglobulin(Uβ2M),urine transferrin(UTRF)and urine immunoglobulin(UIgG)]were compared.And the correlation between UmAlb,Uβ2MG,UTRF,UIgG,GFR and other indexes was analyzed.Results There were no significant differences in GFR,serum SCr,BUN,UmAlb,Uβ2MG,UTRF and UIgG between CKD phase G1 group and control group(P>0.05).As compared with those in control group,the levels of GFR in phase G1group^phase G5 group were significantly decreased with the progression of CKD stage,however,the levels of UmAlb,Uβ2MG,UTRF and UIgG were significantly increased(P<0.05).The serum levels of SCr and BUN in phase G3group^phase G5 group were significantly increased(P<0.05).The levels of 24 h Up and ACR in phase G1group^phase G5 group were significantly increased(P<0.05).Moreover,Spearman correlation analysis showed that UmAlb,Uβ2MG,UTRF,UIgG were negatively correlated with GFR(P<0.05).UmAlb was positively correlated with Uβ2MG,UTRF and UIgG(P<0.05).Uβ2MG was positively correlated with UTRF and UIgG(P<0.05).UTRF was positively correlated with UIgG(P<0.05).Conclusion With the progression of CKD stage,urine microprotein increases gradually,which is of great value for early diagnosis,staging monitoring and prognosis evaluation of the disease.

关 键 词：尿生化指标 慢性肾病 分期 诊断价值 

分 类 号：R692[医药卫生—泌尿科学]