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目的 动态监测肾功能多指标联检、观察全身炎症反应综合征 (SIRS)至多脏器功能障碍综合征 (MODS)时肾功能的变化 ,肾脏损害部位及程度。寻找一个安全、可靠、简便易推广的早期诊断急性肾功衰竭的方法。方法 选择我院急诊ICU符合SIRS标准 5 6例 ,其中 2 9例发生急性肾功能衰竭。采用放射免疫法测定血内皮素 (ET)、尿微量蛋白系列 :尿白蛋白(ALB)、尿免疫球蛋白G (IgG)、尿转铁蛋白 (TRF)、α1-微球蛋白 (α1-MG)、β2 -微球蛋白(β2 MG) ,并与常规尿蛋白、血BUN、Cr进行比较 ,并计算排钠指数。结果 肾功多指标联测总阳性率及单项指标阳性率均高于血BUN、Cr、常规尿蛋白的阳性率。差异有显著意义 ,P <0 0 1。尿微量蛋白系列的变化可出现在SIRS期早于传统生化指标和常规尿蛋白的测定。结论 肾功多指标联检的动态监测可作为判断SIRS期至MODS早期肾功能状态的又一临床指标。对指导临床、防治MODS的发生、评估预后有一定的实用价值
Objective To dynamically monitor multiple indexes of renal function and observe the change of renal function and the location and extent of renal damage in systemic inflammatory response syndrome (SIRS) to multiple organ dysfunction syndrome (MODS). Looking for a safe, reliable, easy to promote the early diagnosis of acute renal failure. Methods Fifty-six patients with acute ICU in our hospital were selected according to SIRS criteria, including 29 cases of acute renal failure. Radioimmunoassay was used to detect the levels of endothelin (ET) and urinary microalbuminuria (ALB), urinary IgG, TRF, α1-MG ), Β2 - microglobulin (β2 MG), and compared with routine urinary protein, blood BUN and Cr, and calculate the excretion of sodium index. Results The positive rate of multi-index of renal function and the positive rate of single index were all higher than those of BUN, Cr and routine urine protein. The difference was significant (P <0.01). Changes in the urinary microalbumin series can occur earlier in SIRS than in traditional biochemical assays and in routine urinary protein assays. Conclusion The dynamic monitoring of multi-index renal function test can be used as another clinical indicator to judge the renal function status from SIRS to early MODS. To guide the clinical prevention and treatment of MODS, the prognosis of a certain practical value