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目的研究探讨尿肾功早期损害检测指标在慢性肾病诊断、监测中的应用。方法选取2014年1月至2016年6月至我中心就诊的慢性肾脏病患者180例,依据临床诊断标准及肾脏穿刺确诊的疾病类型,分为高血压肾脏病组、糖尿病肾脏病组、隐匿性肾炎组各60例,另选60例健康人群作为对照组,分别检测4组患者晨尿中微量清蛋白(UmA1b)、尿转铁蛋白(TRU)、尿α1微球蛋白(Uα1-MG)、尿β2微球蛋白(uβ2-MG)的水平,同时分别检测4组患者血液肌酐(SCr)及尿素氮(BUN)水平;观察分析与比较三组患者上述检测指标。结果高血压肾脏病、糖尿病肾脏病及隐匿性肾炎组患者的UmA1b、TRU、uα1-MG、uβ2-MG等指标水平均显著高于对照组患者,其差异具有统计学意义(P<0.05);高血压肾脏病、糖尿病肾脏病组患者的SCr及BUN水平均显著高于对照组患者,其差异具有统计学意义(P<0.05);而隐匿性肾炎组患者的SCr及BUN水平与对照组无明显差异(P>0.05);且慢性肾脏病严重程度与尿肾功早期损害指标呈正相关。结论尿肾功早期损害检测指标是慢性肾病早期诊断和病情监测的重要指标,在慢性肾病诊断、监测中具有重要的意义,值得临床上进一步应用推广。
Objective To investigate the application of urinary nephronosis early detection in the diagnosis and monitoring of chronic kidney disease. Methods 180 patients with chronic kidney disease admitted to our center from January 2014 to June 2016 were divided into hypertension nephropathy group, diabetic nephropathy group and occult group according to the clinical diagnostic criteria and the type of diseases confirmed by renal puncture. 60 patients in nephritis group and 60 healthy people in another group were selected as the control group. UmA1b, urinary transferrin (TRU) and urinary α1 microglobulin (Uα1-MG) Urinary β2-microglobulin (uβ2-MG) levels were measured. Blood creatinine (SCr) and blood urea nitrogen (BUN) levels were measured in four groups at the same time. The above indexes were observed and compared among the three groups. Results The levels of UmA1b, TRU, uα1 - MG and uβ2 - MG in hypertension nephropathy, diabetic nephropathy and occult nephritis were significantly higher than those in control group (P <0.05). The levels of SCr and BUN in hypertensive kidney disease and diabetic nephropathy patients were significantly higher than those in the control group (P <0.05), while the levels of SCr and BUN in patients with occult nephritis were significantly lower than those in the control group (P> 0.05). The severity of chronic kidney disease was positively correlated with the index of early renal damage. Conclusion Early detection of urinary renal damage indicators is an important indicator of early diagnosis and monitoring of chronic kidney disease in the diagnosis and monitoring of chronic kidney disease is of great significance, it is worth further clinical application of promotion.