尿β2-MG、γ-GT联合检测诊断职业性铅中毒患者肾损伤临床价值分析  

Analysis on clinical value of combined detection of urineβ2-MG andγ--GT in diagnosis of renal injury in patients with occupational lead poisoning

作　　者：曾晓云 陈维阳 ZENG Xiao-yun;CHEN Wei-yang(Laboratory Department,Jingmen Second People's Hospital,Jingmen Hubei,448000,China;Infectious Disease Department,Jingmen Second People's Hospital,Jingmen Hubei,448000,China)

机构地区：[1]荆门市第二人民医院检验科,湖北荆门448000 [2]荆门市第二人民医院传染科,湖北荆门448000

出　　处：《职业与健康》2023年第12期1604-1607,共4页Occupation and Health

摘　　要：目的探究尿β2-微球蛋白(urineβ2-microglobulin,β2-MG)、γ-谷氨酰转移酶(γ-Glutamyltransferase,γ-GT)联合检测诊断职业性铅中毒患者肾损伤的临床价值。方法选择2020—2022年荆门市第二人民医院收治的职业性铅中毒患者98例作为观察组,选择同时期存在职业性铅暴露但血铅水平正常者72例及无铅暴露史且血铅水平正常的正常健康检查者67例,分别作为对照组与健康组。检测3组调查对象血铅值及锌原卟啉(zinc protoporphyrin,ZPP)含量,并收集血液及尿液标本,检测血尿酸(uric acid,UA)、肌酐(creatinine,Cr)、尿素氮(urea nitrogen,BUN)及尿β2-MG、γ-GT水平,以24 h血清尿蛋白排泄率(urinary protein excretion rate,UAER)30 mg/24 h作为肾损伤的“金标准”,用受试者工作特征(receiveroperatingcharacteristic,ROC)曲线分析尿β2-MG、γ-GT单独及联合检测对职业性铅中毒患者肾损伤的诊断效能。结果观察组、对照组、健康组血铅值分别为(631.37±113.85)、(70.13±19.62)和(22.59±5.21)μg/L,ZPP含量分别为(3.12±0.36)、(2.85±0.29)、(2.51±0.27)μmol/L,差异均有统计学意义(均P<0.05);3组血UA、Cr、BUN值比较,差异均无统计学意义(均P>0.05);观察组、对照组、健康组尿β2-MG分别为(0.93±0.30)、(0.17±0.04)和(0.13±0.02)mg/L,γ-GT值分别为(91.35±10.62)、(32.28±8.15)和(26.13±5.24)U/L,差异有统计学意义(P<0.05);ROC曲线分析结果显示,尿β2-MG、γ-GT联合检测诊断职业性铅中毒肾损伤敏感性、特异性、线下面积分别为95.90%、94.40%、0.952,明显高于两者单独检测,且差异有统计学意义(P<0.05)。结论尿β2-MG、γ-GT联合检测可作为职业性铅中毒患者肾损伤的重要指标,在临床中诊断价值较高。Objective To explore the clinical value of combined detection of urineβ2-microglobulin(β2-MG)and-glutamyl transferase(γ--GT)in the diagnosis of renal injury in patients with occupational lead poisoning.Methods A total of 98 occupational lead poisoning patientsadmitted to the Jingmen Second People's Hospital from January 2020 to January 2022 were selected as the observation group.Meanwhile,72 individuals with occupational lead exposure but with normal blood lead level were selected as the control group,and 67 individuals without lead exposure history and with normal blood lead level were selected as the healthy group.The levels of blood lead and zinc protoporphyrin(ZPP)in the three groups of subjects were detected.The blood and urine samples were collected to detect the levels of serum uric acid(UA),creatinine(Cr)and blood urea nitrogen(BUN),urineβ2-MG and γ--GT.The 24h urinary albumin excretion rate(UAER)of 30mg/24h was taken as the golden standard for kidney injury to analyze the performance ofβ2-MG, γ--GT alone and in combination to diagnose renal injury in patients with occupational lead poisoning using the receiver operating characteristic(ROC)curve.Results The blood lead levelin the observation group,the control group and the healthy group was(631.37±113.85),(70.13±19.62)and(22.59±5.21)μg/L,respectively.The ZPP level was(3.12±0.36),(2.85±0.29)and(2.51±0.27)μmol/L,respectively.All differences were statistically significant(all P<0.05).There were no statistically significant differences levels of blood UA,Cr and BUN among the three groups(all P>0.05).The urineβ2-MG level in the observation group,the control group and the healthy group was(0.93±0.30),(0.17±0.04)and(0.13±0.02)mg/L,respectively.The γ--GT level was(91.35±10.62),(32.28±8.15)and(26.13+5.24)U/L,respectively.All differenceswere statistically significant(all P<0.05).The ROC curve analysis showed that the sensitivity,specificity and area under the curve of urineβ2-MG combined with γ--GT to diagnose kidney injury in occupational l

关 键 词：铅中毒 肾损害 Β2-微球蛋白 Γ-谷氨酰转移酶 

分 类 号：R135.11[医药卫生—劳动卫生]