CAJ | 학술논문

目的探讨血尿联合检测在急性有机磷农药中毒(AOPP)肾脏损害早期诊断中的价值.方法选取并发肾损害的63例AOPP患者,其中轻度中毒12例(轻度组),中重度中毒51例(中重度组).另择同期体检健康者30例作为对照组.检测比较3组对象血胱氨酸蛋白酶抑制剂C(CysC)、Scr、血清胆碱酯酶(chE)及尿微量白蛋白(mAlb)、a1-微球蛋白(a1-MG)、N-乙酰-β-D氨基葡萄糖苷酶(NAG)含量,并分析血尿指标的相关性.结果63例AOPP患者中60岁以上者明显多于21~40、41~60岁者(P<0.05).与对照组比较,轻度组及中重度组血清chE活力明显下降(P<0.05或0.01),血Scr、CysC及尿mAlb、a1-MG、NAG明显升高(P<0.05或0.01);与轻度组比较,中重度组血清chE活力显著下降(P<0.01),血Scr、CysC及尿mAlb、a1-MG、NAG均显著升高(均P<0.01).尿mAlb、a1-MG、NAG含量均与血清chE活力呈负明显相关(r=-0.23、-0.48、-0.43,P<0.05或0.01).结论AOPP的严重程度与肾功能损害的严重程度一致,易发生于老年患者,血CysC及尿mAlb、a1-MG、NAG的变化与肾脏损害的严重程度也是一致的,血尿联合检测有助于AOPP早期肾损害的诊断.
목적탐토혈뇨연합검측재급성유궤린농약중독(AOPP)신장손해조기진단중적개치.방법선취병발신손해적63례AOPP환자,기중경도중독12례(경도조),중중도중독51례(중중도조).령택동기체검건강자30례작위대조조.검측비교3조대상혈광안산단백매억제제C(CysC)、Scr、혈청담감지매(chE)급뇨미량백단백(mAlb)、a1-미구단백(a1-MG)、N-을선-β-D안기포도당감매(NAG)함량,병분석혈뇨지표적상관성.결과63례AOPP환자중60세이상자명현다우21~40、41~60세자(P<0.05).여대조조비교,경도조급중중도조혈청chE활력명현하강(P<0.05혹0.01),혈Scr、CysC급뇨mAlb、a1-MG、NAG명현승고(P<0.05혹0.01);여경도조비교,중중도조혈청chE활력현저하강(P<0.01),혈Scr、CysC급뇨mAlb、a1-MG、NAG균현저승고(균P<0.01).뇨mAlb、a1-MG、NAG함량균여혈청chE활력정부명현상관(r=-0.23、-0.48、-0.43,P<0.05혹0.01).결론AOPP적엄중정도여신공능손해적엄중정도일치,역발생우노년환자,혈CysC급뇨mAlb、a1-MG、NAG적변화여신장손해적엄중정도야시일치적,혈뇨연합검측유조우AOPP조기신손해적진단.
Objective To assess the blood and urine tests for early diagnosis of kidney injury in patients with acute organophosphorus pesticide poisoning (AOPP). Methods Sixty three patients with AOPP were enrolled in the study, including 12 cases of low-grade poisoning (mild group) and 51 cases of mid-severe poisoning (mid-severe group). Thirty healthy sub-jects were used as control group.The serum cystatin C (CysC), creatinine (Scr), cholinesterase(chE)and urinary microalbumin (mAlb), a1-microglobulin (a1-MG), N-acetyl-β-d-glucosaminidase (NAG) levels were tested and compared among three groups. Results Serum chE levels in two groups of AOPP patients were significantly lower than those in control group (P<0.05 or 0.01);serum Scr, CysC and urinary mAlb, a1-MG, NAG were significantly higher than those in control group (P<0.05 or 0.01). Serum chE levels in mid-severe AOPP patients were significantly lower, and serum Scr, CysC and urinary mAlb, a1-MG, NAG were significantly higher than those in mild group (al P<0.01). Urinary mAlb, a1-MG and NAG levels were negatively correlated with serum chE levels(r=-0.23,-0.48 and-0.43,respectively, P<0.05 or 0.01). Conclusion The severity of AOPP is correlated with kidney injury. Serum cysc and urinary mAlb, a1-MG, NAG level are correlated with the severity of kidney injury in AOPP pa-tients, indicating that blood and urine tests can be used as early indicators of kidney injury in AOPP patients.