尿微量蛋白测定对高血压肾损害早期诊断的意义(1)
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【摘要】目的: 观察尿白蛋白(Alb)、α1-微球蛋白(α1-MG)、β2-微球蛋白(β2-MG)、免疫球蛋白G(IgG)等微量蛋白对高血压病肾损害早期诊断的价值。方法: 应用放射免疫分析(RIA)方法，对210例高血压病患者及60例正常对照者尿Alb、α1-MG、β2-MG、IgG等进行检测。结果210例高血压病患者尿中Alb、α1-MG、β2-MG、IgG含量均高于正常对照组，但仅β2-MG二者结果之间存在显著性差异(P<0.05)。随着高血压患者的病情分期的加重，尿中Alb、α1-MG、β2-MG、IgG水平均呈现出逐渐增高的趋势，以Ⅲ组升高最为明显，而且与正常对照组检测结果之间均存在显著性差异(P<0.01或0.05)。210例高血压病患者尿中Alb、α1-MG、β2-MG、IgG阳性例数分别为5例(2.4%)、4例(1.9%)、15例(7.1%)、6例(2.9%)，阳性病例基本出现在高血压病Ⅲ组。结论: 尿中Alb、α1-MG、β2-MG、IgG等微量蛋白的检测对于判断高血压病患者有无早期肾损害及损害的程度具有重要意义。
【关键词】高血压病;肾损害；尿；微量蛋白
Significance of early diagnosis of hypertensive renal damage by detection urinary microproteins
REN Zeng-fang
【Abstract】 Objective To study the value of determination of micro-albumin(mALB), α1-microglobulin(α1-MG), β2-microglobulin(β2-MG) and immunoglobulin G(IgG) in early diagnosis of hypertensive renal damage. MethodsUrine levels of Alb, α1-MG, β2-MG and IgGwere detected by radioimmunoassay (RIA) in 200 hypertension patients and 50 normal controls. Results Urine levels of Alb, α1-MG, β2-MG and IgG in hypertension patients were higher than those in normal controls, but only urine levels of β2-MG in hypertension patients were higher than those in normal controls significantly(P<0.05). With the aggravated staging of hypertension patients, urine levels of Alb, α1-MG, β2-MG and IgG were shown the trend of gradually increasing, especially the most in Ⅲ group, and there were significant differences in hypertension groups and normal controls(P<0.01 or 0.05). Positive cases of urine Alb, α1-MG, β2-MG, IgG in 200 hypertension patients were 5 cases (2.4%), 4 cases (1.9%), 15 cases (7.1%), 6 cases (2.9%),and most of the positive cases appeared in Ⅲ hypertension group. Conclusion It was important for judging the early renal damage and the extent of renal damage in hypertension by detecting urine levels of Alb, α1-MG, β2-MG and IgG.
【Key words】hypertension; renal damage; urine; microproteins
【中图分类号】R446.13【文献标识码】B【文章编号】1008-6455(2011)08-0379-02
高血压在临床上较为常见，其发病与肾脏关系密切。一方面，肾脏通过体液调节参与血压的形成，一旦这种调节失衡将导致高血压发生；另一方面肾脏也是高血压相关损害的重要靶器官之一。高血压和肾脏损害互为因果，互相促进，存在恶性循环。绝大多数临床所见的高血压肾损害是良性高血压肾硬化(benign hypertensive nephrosclerosis，BHN)，是导致终末期肾病(ESRD)的重要原因之一 ......
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