CAJ | 학술논문

目的：探讨尿α1-微球蛋白（α1-MG)检测在肾损害早期诊断中的应用价值。方法选择2013年12月—2014年4月在我院肾病病区诊断为早期肾损害患者73例作为肾病组（根据尿蛋白水平又分为尿蛋白阳性亚组44例和尿蛋白阴性亚组29例),另选取同期体检健康者40例作为对照组。两组均留取晨尿,采用免疫速率散射比浊法检测α1-MG 和β2-微球蛋白（β2-MG)水平,比较二者相关性、阳性率,采用受试者工作特征（ROC)曲线评价二者的诊断效能。结果肾病组尿α1-MG 及β2-MG 水平明显高于对照组,差异有统计学意义（U =16．00,P =0．000；U =576．50,P =0．000)；且二者呈明显正相关（ r =0．732,P =0．000)。肾病组尿α1-MG 和β2-MG 的阳性率分别为84．93%和69．86%,差异有统计学意义（χ2=4．737,P =0．030),尿蛋白阳性亚组二者阳性率差异无统计学意义（χ2=3．438,P =0．064),尿蛋白阴性亚组二者阳性率差异亦无统计学意义（χ2=1．758,P =0．185)。诊断效能分析显示：α1-MG的诊断准确度高于β2-MG。结论尿α1-MG 和β2-MG 对早期肾损害均有较高诊断准确度,α1-MG 受实验室温度及尿液酸碱度等影响小,敏感性高于β2-MG,可能更适合用于早期肾损害的诊断。
목적：탐토뇨α1-미구단백（α1-MG)검측재신손해조기진단중적응용개치。방법선택2013년12월—2014년4월재아원신병병구진단위조기신손해환자73례작위신병조（근거뇨단백수평우분위뇨단백양성아조44례화뇨단백음성아조29례),령선취동기체검건강자40례작위대조조。량조균류취신뇨,채용면역속솔산사비탁법검측α1-MG 화β2-미구단백（β2-MG)수평,비교이자상관성、양성솔,채용수시자공작특정（ROC)곡선평개이자적진단효능。결과신병조뇨α1-MG 급β2-MG 수평명현고우대조조,차이유통계학의의（U =16．00,P =0．000；U =576．50,P =0．000)；차이자정명현정상관（ r =0．732,P =0．000)。신병조뇨α1-MG 화β2-MG 적양성솔분별위84．93%화69．86%,차이유통계학의의（χ2=4．737,P =0．030),뇨단백양성아조이자양성솔차이무통계학의의（χ2=3．438,P =0．064),뇨단백음성아조이자양성솔차이역무통계학의의（χ2=1．758,P =0．185)。진단효능분석현시：α1-MG적진단준학도고우β2-MG。결론 뇨α1-MG 화β2-MG 대조기신손해균유교고진단준학도,α1-MG 수실험실온도급뇨액산감도등영향소,민감성고우β2-MG,가능경괄합용우조기신손해적진단。
Objective To explore the value of urinary α1-microglobulin (α1-MG) detection in the early diagnosis of renal damage. Methods A total of 73 patients with renal damage in early period during December 2013 and April 2014 were selected as nephropathy group, who were divided into positive urinary protein subgroup (group A, n = 44) and negative urina-ry protein subgroup (group B, n = 29) according to the urinary protein level, and 40 healthy persons at the same time were chosen as control group. Urina sanguinis were collected in the two groups. In the two groups, the levels of α1-MG and β2-mi-croglobulin (β2-MG) were detected by immune rate nephelometry to compare the correlation and positive rate of the two lev-els, and diagnostic efficacy was evaluated using receiver operating curve (ROC). Results The levels of α1-MG and β2-MG in nephropathy group were significantly higher than those in control group, and the differences were statistically significant (U = 16. 00, P = 0. 000; U = 576. 50, P = 0. 000); urinary α1-MG positively correlated with β2-MG ( r = 0. 732, P =0. 000). The positive rates of urinary α1-MG and β2-MG in nephropathy group were 84. 93% and 69. 8% respectively, and the difference was statistically significant (χ2 = 4. 737, P = 0. 030), but the difference in positive rate in the positive urine protein subgroup was not statistically significant (χ2 = 3. 138, P = 0. 064), and the difference in positive rate in the negative urine protein subgroup was not statistically significant (χ2 = 1. 758, P = 0. 185). The diagnostic efficacy analysis showed that the accuracy level of α1-MG was higher than that of β2-MG. Conclusion Urinary α1-MG and β2-MG has high diagnostic ac-curacy for renal damage in early period, α1-MG is less influenced by the laboratory temperature and urine pH, and the sensi-tivity is higher than that of β2-MG, so α1-MG may be more suitable for diagnosis of renal damage in preliminary period.