CAJ | 학술논문

目的探讨尿轻链检测在原发性高血压肾脏损伤中的诊断价值.方法参照<中国高血压防治指南>(2005年修订版),根据原发性高血压肾脏损害诊断标准,结合病史及靶器官受损情况,选取原发性高血压患者60例,分为两组:无肾脏损伤组28例,肾脏损伤组32例;另设健康对照组30名.采用散射免疫比浊法原理检测尿蛋白谱、尿轻链,应用MNP底物法检测NAG.比较各组尿轻链水平,并与Alb及α1-MG进行相关分析.结果高血压肾脏损伤组lamU为8.89(3.84～33.30)×10-3g/L,高于无肾脏损伤组的3.84(3.84～10.40)×10-3g/L和健康对照组的3.84(0.00～3.84)×10-3g/L,差异有统计学意义(H=37.97,P＜0.01);高血压肾脏损伤组kapU为26.65(6.97～62.5)×10-3 g/L,高于无肾脏损伤组的6.97(6.97～23.7)×10-3g/L和健康对照组的6.97(6.97～7.20)×10-3g/L,差异有统计学意义(H=40.09,P＜0.01).高血压肾脏损伤组其他指标(Alb、α1-MG、IgG、TRF及NAG)检测结果均高于无肾脏损伤组、健康对照组(H值分别为21.02、32.65、25.50、30.45和30.57,P均＜0.01).相关分析结果显示,Alb与尿IgG、TRF的相关系数分别为0.911、0.965,呈高度相关(P均＜0.01);尿轻链lamU、kapU与α1-MG相关系数分别为0.804、0.827,呈高度相关(P均＜0.01);而NAG与α1-MG不相关(相关系数为0.398,P＞0.05).结论尿轻链lamU、kapU可以作为评价高血压肾脏损伤,特别是肾小管损伤的诊断指标.
목적 탐토뇨경련검측재원발성고혈압신장손상중적진단개치.방법 삼조<중국고혈압방치지남>(2005년수정판),근거원발성고혈압신장손해진단표준,결합병사급파기관수손정황,선취원발성고혈압환자60례,분위량조:무신장손상조28례,신장손상조32례;령설건강대조조30명.채용산사면역비탁법원리검측뇨단백보、뇨경련,응용MNP저물법검측NAG.비교각조뇨경련수평,병여Alb급α1-MG진행상관분석.결과 고혈압신장손상조lamU위8.89(3.84～33.30)×10-3g/L,고우무신장손상조적3.84(3.84～10.40)×10-3g/L화건강대조조적3.84(0.00～3.84)×10-3g/L,차이유통계학의의(H=37.97,P＜0.01);고혈압신장손상조kapU위26.65(6.97～62.5)×10-3 g/L,고우무신장손상조적6.97(6.97～23.7)×10-3g/L화건강대조조적6.97(6.97～7.20)×10-3g/L,차이유통계학의의(H=40.09,P＜0.01).고혈압신장손상조기타지표(Alb、α1-MG、IgG、TRF급NAG)검측결과균고우무신장손상조、건강대조조(H치분별위21.02、32.65、25.50、30.45화30.57,P균＜0.01).상관분석결과현시,Alb여뇨IgG、TRF적상관계수분별위0.911、0.965,정고도상관(P균＜0.01);뇨경련lamU、kapU여α1-MG상관계수분별위0.804、0.827,정고도상관(P균＜0.01);이NAG여α1-MG불상관(상관계수위0.398,P＞0.05).결론 뇨경련lamU、kapU가이작위평개고혈압신장손상,특별시신소관손상적진단지표.
Objective To investigate the diagnostic value of urinary light chain detection in essential hypertension renal injury. Methods According to "National Prevention and Treatment Guide of Hypertension" (2005 Edition) and the diagnostic criteria of essential hypertension renal injury, patients'medical history and damage of target organs, we selected 60 patients with essential hypertension and divided them into two groups: 28 patients without renal injury and 32 patients with renal injury. Meanwhile, Thirty healthy individuals were included in a control group. Urinary proteins and light chains were detected by immuonephelometry and the activity of NAG was determined by liquid kinetic rate assay with MNP as substrate. The urinary light chains concentration of each group were compared and analyzed with those of Alb and α1-MG. Results The results of lamU in renal injury group [8. 89(3.84-33. 30) mg] were higher than those of non renal injury group [3. 84(3. 84-10. 4) mg] and control group [3.84(0. 00-3.84) mg]. There was statistically significant difference ( H = 37.97, P ＜ 0. 01 ). The levels of kapU in renal injury group [26. 65 (6. 97-62. 5 ) mg] were higher than those of non renal injury group [6. 97 (6. 97-23.7 )mg] and control group [6. 97(6. 97-7. 20) mg], which also had statistical significance (H =40. 09,P ＜0. 01 ). All the other results in renal injury group ( Alb, α1-MG, IgG, TRF and NAG) were higher than those of non renal injury group and control group ( H =21.02, 32. 65, 25.50, 30. 45 and 30. 57, P ＜0. 01 ). Correlation analysis showed that Alb levels were highly correlated with urinary IgG and TRF levels [Correlation coefficient (r) =0. 911, 0. 965, P ＜ 0. 01]. The levels of urinary light chain lamU and kapU were also highly correlated with α1-MG ( r = 0. 804, 0. 827, P ＜ 0. 01 ). However, There was no correlationship between NAG and α1MG levels (r=0. 398,P＞0. 05). Conclusion The urinary light chain lamU and kapU can be used as indicators for evaluation of renal injury in essential hypertension, especially renal tubular injury.