血清及尿β_(2)微球蛋白、视黄醇结合蛋白、水通道蛋白-2与肾盂输尿管连接部梗阻致小儿肾积水严重程度的关系研究  

Relationships ofβ_(2)-microglobulin,retinol binding protein and aquaporin-2 in serum and urine with the severity of hydronephrosis induced by ureteropelvic junction obstruction in children

作　　者：邓宏达 邓洪辉[2] 黄韦政 DENG Hongda;DENG Honghui;HUANG Weizheng(Department of Urological Surgery,the Sixth People′s Hospital of Nanning of Guangxi Zhuang Autonomous Region,Nanning,Guangxi,530001;Department of Pediatric Surgery,the First People′s Hospital of Nanning of Guangxi Zhuang Autonomous Region,Nanning,Guangxi,530016)

机构地区：[1]广西壮族自治区南宁市第六人民医院泌尿外科,广西南宁530001 [2]广西壮族自治区南宁市第一人民医院小儿外科,广西南宁530016

出　　处：《实用临床医药杂志》2024年第10期58-62,共5页Journal of Clinical Medicine in Practice

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题项目(Z20211113)。

摘　　要：目的探讨血清及尿β_(2)微球蛋白(β_(2)-MG)、视黄醇结合蛋白(RBP)、水通道蛋白-2(AQP2)与肾盂输尿管连接部梗阻(UPJO)致小儿肾积水严重程度的关系。方法选取南宁市第六人民医院泌尿外科接受肾盂输尿管梗阻手术治疗的60例肾积水患儿为肾积水组,根据肾积水严重程度分为轻度组(n=13)、中度组(n=22)和重度组(n=25),另外选取同期该院接受体检的60例健康儿童为对照组。比较对照组和肾积水组不同严重程度患儿血清及尿β_(2)-MG、RBP、AQP2水平;分析β_(2)-MG、RBP、AQP2水平与超声参数[肾盂前后径(APD)、肾实质厚度(PT)]的相关性;采用受试者工作特征(ROC)曲线分析血清及尿β_(2)-MG、RBP、AQP2对中重度肾积水的诊断效能。结果肾积水组血清及尿β_(2)-MG、RBP水平均高于对照组,血清及尿AQP2水平均低于对照组,差异有统计学意义(P<0.05)。肾积水患儿血清β_(2)-MG、尿β_(2)-MG、尿RBP水平和APD水平由低到高为轻度组、中度组、重度组,尿AQP2水平和PT由高到低为轻度组、中度组、重度组,差异均有统计学意义(P<0.05)。轻度组血清RBP水平低于中度组和重度组,差异有统计学意义(P<0.05)。肾积水患儿血清β_(2)-MG、尿β_(2)-MG、尿RBP水平与APD均呈正相关,与PT均呈负相关(P<0.05);尿AQP2水平与APD呈负相关,与PT呈正相关(P<0.05)。ROC曲线分析结果显示,血清β_(2)-MG、尿β_(2)-MG、尿RBP、尿AQP2检测对中重度肾积水均具有一定诊断价值,曲线下面积(AUC)分别为0.652、0.688、0.859、0.680,尿RBP诊断中重度肾积水的AUC显著大于其余指标(P<0.05)。结论血清β_(2)-MG、尿β_(2)-MG、尿RBP、尿AQP2与UPJO致小儿肾积水严重程度相关,尿RBP对中重度肾积水的诊断效能优于其他指标。Objective To explore the relationships of β_(2)-microglobulin(β_(2)-MG),retinol binding protein(RBP)and aquaporin-2(AQP2)in serum and urine with the severity of hydronephrosis induced by ureteropelvic junction obstruction(UPJO)in children.Methods Sixty children with hydronephrosis who underwent surgery for UPJO at the Department of Urology of the Sixth People′s Hospital of Nanning were selected as hydronephrosis group.According to the severity of hydronephrosis,they were divided into mild group(n=13),moderate group(n=22),and severe group(n=25).Meanwhile,60 healthy children in the same period were selected as the control group.The serum and urine levels of β_(2)-MG,RBP and AQP2 were compared between control group and children with hydronephrosis of hydronephrosis group.The correlation between the levels of β_(2)-MG,RBP,AQP2 and ultrasound parameters[anteroposterior diameter of renal pelvis(APD),parenchymal thickness(PT)J was analyzed.The receiver operating characteristic(ROC)curves were used to analyze the diagnostic efficacy of β_(2)-MG,RBP and AQP2 in serum and urine for moderate to severe hydronephrosis.Results The levels of β_(2)-MG and RBP in serum and urine of the hydronephrosis group were higher than those in the control group,and the levels of AQP2 in serum and urine were lower than those in the control group(P<0.05).The levels ofβ_(2)-MG inserum and urine,RBP in urine,and APD from low to high in different groups were as follows:mild group,moderate group to severe group.Urine AQP2 level and PT from high to low in dfferent groups was as fllows:mild group,moderate group to severe group(P<0.05).Serum RBP level in the mild group was lower than those in the moderate group and the severe group(P<0.05).Urinary AQP2level was negatively correlated with APD and positively correlated with PT(P<0.05).ROC curve analysis results showed that serumβ_(2)-MG,urine β_(2)-MG,urine RBP,urine AQP2 detection had certain diagnostic value in moderate and severe hydronephrosis,and the area under the curve(AUC)was 0.652,0

关 键 词：肾盂输尿管连接部 梗阻 肾积水 β_(2)微球蛋白 视黄醇结合蛋白 水通道蛋白-2 

分 类 号：R692.2[医药卫生—泌尿科学] R334[医药卫生—外科学] R319[医药卫生—临床医学]