尿液总蛋白浓度与尿蛋白类型关系的探讨  

A Study of the Relationship Between Total Urine Protein Concentration and Urine Protein Type

作　　者：车冬丽[1] 祁祺 田野[1] 刘晴[1] 王志阳[1] 张磊[1] 谭延国[1] CHE Dongli;QI Qi;TIAN Ye;LIU Qing;WANG Zhiyang;ZHANG Lei;TAN Yanguo(Department of Clinical Laboratory,Fusing Hospital Afiliated to Capital Medical University,Beijing 100038,China;Department of Laboratory Medicise,Capital Medical University,Beijng 100038 China)

机构地区：[1]首都医科大学附属复兴医院检验科,北京100038 [2]首都医科大学医学检验系,北京100038

出　　处：《标记免疫分析与临床》2025年第1期137-141,共5页Labeled Immunoassays and Clinical Medicine

基　　金：北京市临床重点专科医学检验科培育项目(编号:京卫医[2020]129号)。

摘　　要：目的探讨尿液总蛋白浓度(g/L)与尿液蛋白类型(肾小球、肾小管、混合性等)间的关系。方法回顾1092例患者使用同一份样本检测尿液总蛋白浓度和十二烷基硫酸钠-琼脂糖凝胶电泳(SDS-AGE)的结果,并分析SDS-AGE可用于鉴别尿蛋白类型的尿液总蛋白浓度的最佳临界值,以及尿液总蛋白浓度与各种尿蛋白类型样本的构成比、肾小球(或肾小管)蛋白质比例(占总蛋白)间的关系。结果(1)SDS-AGE用于尿液蛋白质分型的最佳临界值为尿液总蛋白浓度0.095g/L;(2)不同尿液总蛋白浓度组(轻度或痕量:0~1g/L;中度:1~4g/L;重度:≥4g/L)各种尿蛋白类型样本的构成比差异具有统计学意义(P<0.001),轻度或痕量组相比中等和重度组,检出单纯性肾小管蛋白尿样本的比例最高(18.82%vs 12.5%、7.41%),混合性蛋白尿的比例最低(44.27%vs 71.32%、70.37%);(3)混合性蛋白尿样本中,肾小管、肾小球蛋白质所占总蛋白的比例,在3个蛋白尿浓度组间差异均具有统计学意义(P=0.001,<0.001),即尿液总蛋白浓度越高,肾小球性蛋白质占总蛋白的比例越高,肾小管性的则越低。结论尿液总蛋白浓度虽与蛋白质类型存在一定关系,但并不能准确反映尿蛋白的组织类型。使用SDS-AGE鉴定尿蛋白类型十分必要。Objective To investigate the relationship between urinary total protein concentration(g/L)and urinary protein types(glomeruli,renal tubules,mixed,etc.).Methods The results of urine total protein concentration and urine protein electrophoresis(SDS AGE)using the same sample from 1092 patients were retrospectively reviewed.Optimal cutoff value of urine total protein concentration in samples that SDS-AGE can be used to effectively identify their urine protein types were analyzed and identified.The relationship between urinary protein concentration and the composition ratio of samples of various urinary protein types,and the proportion of glomerular(or renal tubule)protein(as a proportion of total protein)were also explored.Results(1)Optimal cutoff value of urine protein concentration was 0.095g/L for SDS-AGE to effectively identify protein types;(2)Among different urine protein concentration groups(mild or trace:0-1g/L;Moderate:1-4g/L;Severe:≥4g/L),the composition ratio of urine protein types was significantly different(P<0.001).Compared with moderate and severe groups,the proportion of tubular proteinuria(only tubular protein was detected)samples in mild or trace groups was the highest(18.82%vs 12.5%,7.41%),while the proportion of mixed proteinuria was the lowest(44.27%vs 71.32%,70.37%);(3)For the mixed proteinuria samples,the proportion of both renal tubule and glomerular protein accounted for urine total protein was significantly different among the three levels of proteinuria groups,respectively(P=0.001,<0.001),suggesting the higher the urinary protein concentration,the higher the proportion of glomerular protein,and the lower the proportion of tubular protein.Conclusion Although there is certain correlation between urinary total protein concentration and protein type,the former cannot accurately reflect the urinary protein types.It is necessary to identify urine protein types by SDS-AGE.

关 键 词：尿液SDS-琼脂糖凝胶电泳 尿液总蛋白浓度 尿蛋白类型 肾小球性蛋白 肾小管性蛋白 

分 类 号：R446.12[医药卫生—诊断学]