CAJ | 학술논문

目的：探讨实验室检测在肾病中的应用价值，评估这些标记是否可以预测肾组织学病变，筛选出适合临床的最佳检验组合。方法收集该院2010年12月至2014年3月117例肾活检患者主要的临床资料、病理类型及实验室检查等指标，根据WHO 肾脏病理分级标准和 Katafuchi 半定量积分标准进行分级（Ⅰ、Ⅱ、Ⅲ、Ⅳ级）分组。比较分析各组血清胱抑素 C（CysC）、尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG），尿α1微球蛋白（α1-MG）、尿微量清蛋白（mAlb）和24尿蛋白（U-TP）水平的差异性与肾小球、肾小管间质病理变化的关系；以及各项检测指标在不同分组中的相关性和统计学意义。结果病理分级第Ⅳ级的 NAG、α1-MG 和 CysC 与第Ⅰ、Ⅱ、Ⅲ级比较均有统计学意义（P ＜0.05），U-TP 和 mAlb 在反映肾脏疾疾时具有显著相关性（r＝0.565，P ＝0.000）；NAG 和α1-MG 在反映肾小管间质疾病时也具有显著相关性（r ＝0.509，P ＝0.000）。结论各项检测指标的检测结果上升到一定高度时可以判断患者临床与病理病情进展，说明病情的严重情况；同时根据指标间的相关性和检测效能，筛选 Cys C、mAlb、α1-MG 3个指标联合检测，检测效能大大改进。
목적：탐토실험실검측재신병중적응용개치，평고저사표기시부가이예측신조직학병변，사선출괄합림상적최가검험조합。방법수집해원2010년12월지2014년3월117례신활검환자주요적림상자료、병리류형급실험실검사등지표，근거WHO 신장병리분급표준화 Katafuchi 반정량적분표준진행분급（Ⅰ、Ⅱ、Ⅲ、Ⅳ급）분조。비교분석각조혈청광억소 C（CysC）、뇨N-을선-β-D-안기포도당감매（NAG），뇨α1미구단백（α1-MG）、뇨미량청단백（mAlb）화24뇨단백（U-TP）수평적차이성여신소구、신소관간질병리변화적관계；이급각항검측지표재불동분조중적상관성화통계학의의。결과병리분급제Ⅳ급적 NAG、α1-MG 화 CysC 여제Ⅰ、Ⅱ、Ⅲ급비교균유통계학의의（P ＜0.05），U-TP 화 mAlb 재반영신장질질시구유현저상관성（r＝0.565，P ＝0.000）；NAG 화α1-MG 재반영신소관간질질병시야구유현저상관성（r ＝0.509，P ＝0.000）。결론각항검측지표적검측결과상승도일정고도시가이판단환자림상여병리병정진전，설명병정적엄중정황；동시근거지표간적상관성화검측효능，사선 Cys C、mAlb、α1-MG 3개지표연합검측，검측효능대대개진。
Objective To investigate the value of laboratory testing in kidney diseases and to assess whether these marks can predict the renal histological lesions for screening the best clinical test combination.Methods The main clinical data,pathological types and laboratory examination indexes in 117 patients with renal biopsy in our hospital from December 2010 to March 2014 were collected and graded according to the WHO renal pathological classification standard and the Katafuchi semi-quantitative score standard classification (Ⅰ,Ⅱ,Ⅲ,Ⅳ).The differences in serum CysC,urine NAG,urine alpha 1-MG,urine mAlb and 24 h urine total protein (24h-UTP)level were compared among the various groups and their relations with the glomerulus was analyzed;the correlation and the statistical significance of each index in different groups was analyzed.Results NAG,alpha 1-MG and CysC had statistical differences between in the grade Ⅳgroup and the gradeⅠ,Ⅱ,Ⅲ groups (P <0.05),24h-UTP and mAlb had significant correlation in reflecting the kidney diseases (r=0.565,P =0.000);NAG and alpha 1-MG also had significant correlation in reflec-ting renal tubular interstitial disease (r=0.509,P =0.000).Conclusion The detection results of various detection indicators when rising to a certain height can be used for judging the progression of the patients clinical and pathological condition,illustrating the serious condition of illness;at the same time according to the correlation among the indexes and the detection efficiency,three indi-cators of Cys C,mAlb,alpha 1 - MG are screened out for conducting the combination detection,the detection efficiency could be greatly improved.