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目的探讨急性有机磷农药中毒(AOPP)患者尿视黄醇结合蛋白(uRBP)和尿微量白蛋白(umAlb)水平的变化对肾脏损害的意义。方法83例AOPP患者按中毒程度分成轻度中毒组、中度中毒组、重度中毒组;30例健康人为对照组。各组均测定uRBP、umAlb、血尿素氮(BUN)、血肌酐(SCr)及血清胆碱酯酶(ChE)活力。结果轻、中、重度AOPP患者uRBP含量[(0.13±0.07)、(0.82±0.69)、(1.83±0.79)mgL]、umAlb含量[(16.11±9.13)、(40.15±28.35)、(287.91±195.36)mgL]均高于对照组[(0.09±0.05)、(10.63±7.25)mgL],中、重度AOPP患者BUN水平[(7.31±3.95)、(15.83±9.67)mmolL]和SCr水平[(131.21±38.62)、(196.56±75.69)μmolL]均高于对照组[(5.15±1.57)、(85.38±21.96)μmolL],重度AOPP患者的4个指标水平均高于中度中毒组,差异均有统计学意义(P<0.05或P<0.01)。AOPP患者uRBP、umAlb含量与血清ChE活力呈负相关(r=-0.49,P<0.01;r=-0.24,P<0.05)。结论AOPP患者存在肾脏损害,uRBP与umAlb的联合检测与动态观察可对其肾损害早期诊断。
Objective To investigate the significance of the changes of urinary retinaldehyde binding protein (uRBP) and urinary microalbumin (umAlb) in patients with acute organophosphorus pesticide poisoning (AOPP) on renal damage. Methods 83 cases of AOPP patients were divided into mild poisoning group, moderate poisoning group and severe poisoning group according to the degree of poisoning; 30 healthy people as control group. The levels of uRBP, umAlb, BUN, SCr and ChE in each group were determined. Results The levels of uRBP in patients with mild, moderate and severe AOPP [(0.13 ± 0.07), (0.82 ± 0.69), (1.83 ± 0.79) mgL] and umAlb [(16.11 ± 9.13), (40.15 ± 28.35), (287.91 ± 195.36 ) were significantly higher than those in the control group [(0.09 ± 0.05), (10.63 ± 7.25) mgL], BUN levels in moderate and severe AOPP patients [(7.31 ± 3.95), (15.83 ± 9.67) mmolL] and [ ± 38.62), (196.56 ± 75.69) μmol L] were significantly higher than those in the control group [(5.15 ± 1.57) and (85.38 ± 21.96) μmol L], respectively. The four indicators of severe AOPP patients were higher than those of moderate poisoning group Statistical significance (P <0.05 or P <0.01). AOPP patients uRBP, umAlb content and serum ChE activity was negatively correlated (r = -0.49, P <0.01; r = -0.24, P <0.05). Conclusion AOPP patients have kidney damage. Combined detection and dynamic observation of uRBP and umAlb may be an early diagnosis of renal damage.