肾小球和肾小管功能检测指标在慢性乙型肝炎患者肾损伤检测中联合应用价值  

The Combined Detection Application Value of Glomerular and Tubular Function Indicatorsin Renal Injury in Patients with Chronic Hepatitis B

作　　者：刘海颖 沈从乐 李晓慧 马小艳[1] 王雅杰 LIU Haiying;SHEN Congle;LI Xiaohui;MA Xiaoyan;WANG Yajie(Laboratory Department of Beijing Ditan Hospital Affiliated to Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院检验科,北京100015

出　　处：《标记免疫分析与临床》2023年第11期1821-1824,1835,共5页Labeled Immunoassays and Clinical Medicine

基　　金：国家自然科学基金(编号:82102378)。

摘　　要：目的评估肾小球和肾小管功能检测指标在慢性乙型肝炎患者肾损伤中的联合应用价值。方法以2021年3月至2021年11月于首都医科大学附属北京地坛医院就诊的697例慢性乙型肝炎患者为研究对象,观察患者肾小球功能检测指标[血清肌酐、估算肾小球滤过率(eGFR)、尿微量白蛋白]、肾小管功能检测指标(尿α_(1)-微球蛋白、尿β2-微球蛋白);分析估算肾小球滤过率(eGFR)、尿微量白蛋白、尿α_(1)-微球蛋白及尿β2-微球蛋白的异常检出率,计算各项目联合检测后的异常检出率。结果在697例感染的慢性乙型肝炎患者中,尿β2-微球蛋白异常的检出例数为287(41.18%),尿微量白蛋白的异常检出例数为108(15.49%),同时在108例尿微量白蛋白异常中有60例患者尿β2-微球蛋白异常(8.62%)。eGFR异常的检出例数为89(12.77%),尿微量白蛋白的异常检出例数为108(15.49%),二者联合检测后,异常检出例数为167(23.96%),明显高于单独检测,差异有统计学意义(χ^(2)=29.11,P<0.01;χ^(2)=15.76,P<0.01);尿α_(1)-微球蛋白异常的检出例数为119(17.07%),尿β2-微球蛋白异常的检出例数为287(41.18%),两者异常检出率差异有统计学意义(χ^(2)=98.08,P<0.01);二者联合检测后,异常检出例数为317(45.48%),与单独检测尿α_(1)-微球蛋白差异有统计学意义(χ^(2)=130.84,P<0.01),与单独检测尿β2-微球蛋白差异无统计学意义(P>0.05);当尿微量白蛋白联合尿α_(1)-微球蛋白及尿β2-微球蛋白检测后,异常例数为351(50.36%),明显高于单独检测尿α_(1)-微球蛋白(χ^(2)=172.77,P<0.01)或尿β2-微球蛋白(χ^(2)=11.84,P<0.01),差异有统计学意义;依据eGFR不同分为大于等于90%及小于90%两组,其中,尿微量白蛋白及尿α_(1)-微球蛋白在eGFR<90%组别中,异常检出率分别为25.30%及39.76%,高于eGFR≥90%组(χ^(2)=7.72,P<0.01;χ^(2)=70.4,P<0.01),尿β2-微球蛋白在两组别中差异无统计学意义(P>0.05)。结论在慢性乙型肝Objective To evaluate the combined application value of glomerular and tubular function detection indicators in renal injury in patients with chronic hepatitis B.Methods 697 patients with chronic hepatitis B who visited the Ditan Hospital affiliated to Capital Medical University from March,2021 to November,2021 were selected as the study subjects.We observed these patients’glomerular function indicators(serum creatinine,estimated glomerular filtration rate(eGFR),urinary microalbumin),and renal tubular function indicators(urineα_(1)-microglobulin,urineβ2-microglobulin);We then analyzed the abnormal detection rate of estimated glomerular filtration rate(eGFR),urinary microalbumin,urineα_(1)-microglobulin and urineβ2-microglobulin.We also calculated the abnormal detection rate after joint testing of each project.Results Among 697 infected patients with chronic hepatitis B,the number of detected cases of urinaryβ2-microglobulin abnormalities was 287(41.18%),and the number of detected cases of urinary microalbumin abnormalities was 108(15.49%).Among 108 cases of urinary microalbumin abnormalities,60 patients had urinary abnormalitiesβ2-microglobulin abnormality(8.62%).The number of detected cases of eGFR abnormalities was 89(12.77%),and the number of detected cases of urinary microalbumin abnormalities was 108(15.49%).With the combination of the two tests,the number of detected cases of abnormalities was 167(23.96%),which was significantly higher than that of individual tests(χ^(2)=29.11,P<0.01;χ^(2)=15.76,P<0.01);The number of detected cases of urinaryα_(1)-microglobulin abnormality was 119(17.07%),and the number of detected cases of urinaryβ2-microglobulin abnormalities was 287(41.18%),and there was a statistically significant difference in the detection rate between the two(χ^(2)=98.08,P<0.01);With the combination of the two tests,the number of abnormal cases detected was 317(45.48%),which was statistically significant compared to the individual detection of urinaryα_(1)-microglobulin(χ^(2)=130.84,P<

关 键 词：尿微量白蛋白 尿α_(1)-微球蛋白 尿Β2-微球蛋白 慢性乙型肝炎 

分 类 号：R512.62[医药卫生—内科学]