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目的 :探讨尿白蛋白和α1-微球蛋白在晚期肺癌化疗中对肾功能评价的临床应用价值。方法 :将 10 0例晚期肺癌患者随机分为两组。小剂量顺铂组 5 0例 ,CDDP 6 0mg/m2 。大剂量顺铂组 5 0例 ,CDDP 10 0mg/m2 。分别在化疗前、化疗后 2 4～ 48小时和 3周时测定尿白蛋白和α1-微球蛋白及同期测得的血尿素氮、肌酐进行分析比较。结果 :小剂量顺铂组和大剂量顺铂组其尿中Alb及α1-MG无论从定性 (异常数 ) ,还是定量 (平均值 ) ,在化疗前后均有显著差异 (P <0 .0 5 )。大剂量顺铂组较小剂量顺铂组对肾功能影响更大。两组患者 3周后复查尿Alb及α1-MG完全恢复正常。血BUN、Cr无论从定性 (异常数 ) ,还是从定量 (平均值 )上 ,在化疗前、化疗后 2 4～ 48小时及 3周后均无明显差异 (P >0 .0 5 )。结论 :尿Alb及α1-MG是较血BUN、Cr反映肾功能损害的一项更灵敏的指标 ,能够较早地反映轻微的肾功能损害。
Objective: To explore the clinical value of urinary albumin and α1-microglobulin in the evaluation of renal function in advanced lung cancer chemotherapy. Methods : One hundred and ten patients with advanced lung cancer were randomly divided into two groups. In the low-dose cisplatin group, there were 50 patients with CDDP 60 mg/m2. In the high-dose cisplatin group, 50 patients had CDDP 100 mg/m2. The urinary albumin and α1-microglobulin and the blood urea nitrogen and creatinine measured at the same time were determined before and after chemotherapy, 24 to 48 hours and 3 weeks after chemotherapy. Results: The urinary Alb and α1-MG in the low-dose cisplatin group and the high-dose cisplatin group had significant differences (P <0 5) before and after chemotherapy regardless of qualitative (abnormal number) or quantitative (average). ). Larger doses of cisplatin resulted in greater effects on renal function in the smaller doses of cisplatin. The urine Alb and α1-MG were completely normalized after 3 weeks in both groups. Blood BUN and Cr had no significant difference (P > 0.05) before and after chemotherapy, 24 to 48 hours, and 3 weeks after chemotherapy (both qualitative (abnormal number) and quantitative (average). Conclusions: Urinary Alb and α1-MG are more sensitive indicators of renal function damage than blood BUN and Cr, and can reflect mild renal impairment earlier.