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目的 :研究老年急性脑血管病并渗透性肾病 (ON)患者 (简称ON组 )尿Tamm Horsfall蛋白 (THP)及 β2 微球蛋白 (β2 MG)的变化。方法 :对ON组 2 5例患者 (年龄≥ 6 0岁 )尿THP ,β2 MG ,血清BUN及Cr进行检测 ,并以 18例老年急性脑血管病未合并ON患者为对照组。结果 :ON组尿THP显著低于对照组 ,(9 1± 5 4)mg/ 2 4hvs (31 1± 11 8)mg/ 2 4h ,P <0 0 1,ON组 2 5例患者尿THP均下降 ;ON组尿 β2 MG显著低于对照组 ,(0 34 8± 0 0 6 )mg/ 2 4hvs(0 15 9± 0 0 5 )mg/ 2 4h ,P <0 0 1;ON组血BUN ,Cr均显著高于对照组 (P <0 0 1)。结论 :ON组存在着明显的肾小管间质损伤 ,尿THP及 β2 MG是诊断ON的敏感指标。对老年急性脑血管病患者 ,临床上应注意正确使用高渗脱水剂 ,尽量避免ON的发生
Objective: To investigate the changes of urinary Tamm Horsfall protein (THP) and β2 microglobulin (β2 MG) in elderly patients with acute cerebrovascular disease and patients with penetrating nephropathy (ON). Methods: The urinary THP, β2 MG, serum BUN and Cr levels were measured in 25 patients (≥60 years) in ON group. 18 healthy senile patients with cerebrovascular disease without ON were selected as the control group. Results: The THP in ON group was significantly lower than that in control group (91 ± 54) mg / 2 4hvs (31 1 ± 11 8) mg / 24h, P <0.01 (P <0.01). Compared with control group, the urinary β2 MG in ON group was significantly lower than that in control group (0 34 ± 0 0 6) mg / 2 4hvs (0 15 9 ± 0 0 5) mg / 2 4h , Cr were significantly higher than the control group (P <0 01). CONCLUSION: There is obvious tubulointerstitial damage in ON group. Urinary THP and β2 MG are sensitive indicators for diagnosis of ON. For elderly patients with acute cerebrovascular disease, the clinical should pay attention to the correct use of hypertonic dehydration agent, try to avoid the occurrence of ON