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目的探讨尿微量白蛋白(mALB)、β2-微球蛋白(β2-MG)、N-乙酰β-D-氨基葡萄糖苷酶(NAG)联合检测在高血压肾病早期损伤诊断中的价值。方法根据WHO/ISH标准将高血压病患者126例分为高血压Ⅰ级56例,Ⅱ级70例;根据尿常规检查分为蛋白尿阴性组52例和蛋白尿阳性组74例。分别测定126例高血压患者和120例健康对照组尿液mALB、β2-MG、NAG及血清BUN、Cr水平,并进行比较;分析各组尿mALB、β2-MG、NAG单项及联合检测的异常检出率,并与血清BUN、Cr异常检出率比较。结果与对照组比较,高血压不同分级患者的尿mALB、β2-MG、NAG水平均明显增高(P<0.01或P<0.05),而血清BUN、Cr水平相近(P均﹥0.05)。尿mALB、β2-MG和NAG联合检测异常检出率在高血压Ⅰ级、Ⅱ级患者分别为85.71%和98.57%,明显高于血清BUN(7.14%,8.57%,P<0.01)和Cr(3.57%,7.14%,P<0.01)的异常检出率;在无蛋白尿和有蛋白尿组分别为90.38%和100%,明显高于BUN(5.76%,9.61%,P<0.01)和Cr(5.76%,7.89%,P<0.01)的异常检出率。结论 mALB、β2-MG、NAG联合检测是高血压病肾脏损伤早期诊断灵敏、可靠的实验室指标。
Objective To investigate the value of combined detection of urine microalbumin (mALB), β2-microglobulin (β2-MG) and N-acetyl β-D-glucosaminidase (NAG) in the early diagnosis of hypertensive nephropathy. Methods According to WHO / ISH criteria, 126 cases with hypertension were divided into two groups according to WHO criteria: 56 cases of grade Ⅰ, 70 cases of grade Ⅱ; 52 cases of proteinuria negative and 74 cases of proteinuria positive according to urinalysis. Urinary mALB, β2-MG, NAG and serum levels of BUN and Cr in 126 hypertensive patients and 120 healthy controls were measured and compared. The levels of urinary mALB, β2-MG and NAG in each group were detected individually and in combination Detection rate, and with serum BUN, Cr abnormal detection rate comparison. Results Compared with the control group, the levels of urinary mALB, β2-MG and NAG were significantly increased in patients with different grades of hypertension (P <0.01 or P <0.05), while serum levels of BUN and Cr were similar (all P> 0.05). The detection rates of urinary mALB, β2-MG and NAG were 85.71% and 98.57% respectively in patients with grade Ⅰ and Ⅱ hypertension, which were significantly higher than those of serum BUN (7.14%, 8.57%, P <0.01) and Cr 3.57%, 7.14%, P <0.01). The rate of abnormal detection was 90.38% and 100% respectively in the group without albuminuria and proteinuria, which was significantly higher than that in BUN (5.76%, 9.61%, P <0.01) (5.76%, 7.89%, P <0.01). Conclusion Combined detection of mALB, β2-MG and NAG is a sensitive and reliable laboratory indicator for the early diagnosis of renal damage in hypertensive patients.