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目的探讨检测黄疸型肝炎患者尿液中胆色素类颗粒管型(amorphous bile pigmented granular cast,ABPGC)对筛查患者早期肾功能损害的价值。方法以显微镜检测尿沉渣,尿生化指标通过干化学法测定,并采用酶法分析血清中的Bun、Cr、ALT、AST、TB、DB和IB含量。结果健康对照组、无黄疸的肝炎患者组、无肝病和肾病的其他疾病患者组尿中均未发现ABPGC,而25例黄疸型肝炎患者的尿中有23例(92%)先后检出ABPGC。ABPGC在第1 d和第5 d的阳性检出率高于Cr、Bun升高率,差异有统计学意义(P<0.05),而与Cys-C升高率差异无统计学意义(P>0.05)。结论监测肝炎患者尿中ABPGC的出现对黄疸型肝炎患者肾损害的早期筛查,防止肾功能衰竭,减少死亡率有重要的临床实用价值。
Objective To investigate the value of urine bile pigmented granular castration (ABPGC) in screening patients with jaundice hepatitis for early renal impairment. Methods The urinary sediment was detected by microscope. The biochemical indexes of urine were determined by dry chemical method. The contents of Bun, Cr, ALT, AST, TB, DB and IB in serum were determined by enzymatic method. Results No ABPGC was found in the urine of healthy control group, patients without jaundice hepatitis and other diseases without liver disease and nephropathy. However, 23 cases (92%) of the 25 patients with jaundice hepatitis had ABPGC. The positive detection rate of ABPGC on day 1 and 5 was higher than that of Cr and Bun (P <0.05), while there was no significant difference between the ABPGC and Cys-C (P> 0.05). Conclusion The detection of urinary ABPGC in patients with hepatitis has an important clinical value in early screening of patients with jaundice hepatitis and preventing renal failure and reducing mortality.