尿微量白蛋白与尿肌酐比值及尿NAG检测在肾结石微创手术中的应用价值
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摘要
目的探讨尿微量白蛋白与尿肌酐比值及尿NAG检测在肾结石微创手术中的应用价值。方法选取2014年7月至2015年8月在我院泌尿外科住院的50例肾结石患者作为研究对象,为实验组,选择同期在本院进行体检的健康者50例作为对照组。实验组进行PCNL术,于术前、术后7天、30天分别留取新鲜晨尿,对照组于体检当天留取新鲜晨尿,均检测尿α1-MG、β2-MG、m Alb、NAG、TRF、Ig G及Cr,并计算尿NAG/Cr、m Alb/Cr比值。结果实验组术前α1-MG、β2-MG、m Alb、NAG、TRF及Ig G均明显高于对照组,差异有统计学意义(P<0.05)。实验组尿NAG/Cr、m Alb/Cr显著高于对照组,实验组术后7天尿NAG/Cr明显高于对照组,术后30天尿NAG/Cr明显低于术后7天,差异均有统计学意义(P<0.05);术后7天、30天分别与术前比较,差异无统计学意义(P>0.05)。术后7天、30天尿m Alb/Cr分别与术前比无显著差异。实验组手术前后7天的△NAG/Cr与△m Alb/Cr成正相关,手术前后30天的△NAG/Cr与△m Alb/Cr无相关性。结论尿m Alb与尿肌酐比值及尿NAG是反映早期肾功能损害的敏感指标,能够对早期肾功能损害做出诊断。
Objective To investigate the application value of urinary albumin to creatinine ratio and urinary NAG detection in minimally invasive surgery for renal calculi. Methods Fifty patients with kidney stones in renal calculi( experimental group) and 50 healthy people( control group) were involved in this study. The experimental group was treated with minimally invasive percutaneous nephrolithotomy,the fresh morning urine samples was collected before surgery,7 days after operation and 30 days. The fresh morning urine was collected in control group on the day of physical examination. The urinary α1-MG,NAG,β2-MG,TRF,m Alb,Ig G and Cr levels were detected in both groups,and urinary NAG / Cr and m Alb / Cr ratios were calculated. Results The urinary alpha 1-MG,NAG,TRF,beta 2-MG,m Alb and Ig G levels in experimental group before the surgery were significantly higher than that of control group( P < 0. 05). The urine NAG / Cr and m Al B / Cr ratios in the experimental group were significantly higher than that in the control group( P < 0. 05). The NAG / Cr ratio on 7days after operation in the experimental group was significantly higher than that of control group,and urine NAG / Cr on 30 days was significantly lower than that on 7 days after operation( P < 0. 05). There was no difference on NAG / Cr ratio between 7 days and 30 days after operation( P > 0. 05). The urine m Alb / Cr ratio on7 days and 30 days after surgery had no significant difference compared with preoperative. The delta NAG / Cr was positively correlated with delta m Alb / Cr on 7 days before and after the operation. There was no correlation between NAG / Cr and m Alb / Cr on 30 days before and after the operation. Conclusion Urine creatinine to m Alb ratio and urinary NAG are sensitive indexes in the early impairment of renal function,and they could be used for the diagnosis of early impairment of renal function.
Objective To investigate the application value of urinary albumin to creatinine ratio and urinary NAG detection in minimally invasive surgery for renal calculi. Methods Fifty patients with kidney stones in renal calculi( experimental group) and 50 healthy people( control group) were involved in this study. The experimental group was treated with minimally invasive percutaneous nephrolithotomy,the fresh morning urine samples was collected before surgery,7 days after operation and 30 days. The fresh morning urine was collected in control group on the day of physical examination. The urinary α1-MG,NAG,β2-MG,TRF,m Alb,Ig G and Cr levels were detected in both groups,and urinary NAG / Cr and m Alb / Cr ratios were calculated. Results The urinary alpha 1-MG,NAG,TRF,beta 2-MG,m Alb and Ig G levels in experimental group before the surgery were significantly higher than that of control group( P < 0. 05). The urine NAG / Cr and m Al B / Cr ratios in the experimental group were significantly higher than that in the control group( P < 0. 05). The NAG / Cr ratio on 7days after operation in the experimental group was significantly higher than that of control group,and urine NAG / Cr on 30 days was significantly lower than that on 7 days after operation( P < 0. 05). There was no difference on NAG / Cr ratio between 7 days and 30 days after operation( P > 0. 05). The urine m Alb / Cr ratio on7 days and 30 days after surgery had no significant difference compared with preoperative. The delta NAG / Cr was positively correlated with delta m Alb / Cr on 7 days before and after the operation. There was no correlation between NAG / Cr and m Alb / Cr on 30 days before and after the operation. Conclusion Urine creatinine to m Alb ratio and urinary NAG are sensitive indexes in the early impairment of renal function,and they could be used for the diagnosis of early impairment of renal function.
引文
[1]刘济存.肾结石动态检测尿N-乙酰-β-D氨基葡萄糖苷酶和尿微量白蛋白尿的意义.当代医学,2014,20(7):91.
[2]邓新强,李慧芳,范向平.尿微量蛋白检测对糖尿病早期肾损伤的诊断价值分析.当代医学,2012,18(27):116-117.
[3]陈亮,李建兴,黄晓波,等.肾结石合并肾功能不全患者围手术期尿微量白蛋白与尿肌酐比值检测及意义.北京大学学报(医学版),2011,43(5):757-760.
[4]朱立华.实验诊断学.北京:北京医科大学出版社,2002:309-318.
[5]王露萍,梁卓寅,梁志雄,等.尿NAG、尿微量清蛋白检测在泌尿系结石早期肾损害监测中的临床意义.现代泌尿外科杂志,2005,10(3):134-135.
[6]D’Amico G,Bazzi C.Urinary protein and enzyme excretion as markers of tubular damage.Curr Opin Nephrol Hypertens,2003,12(6):639-643.
[7]彭又生,林绮平,李海涛,等.肾结石患者尿微量蛋白的变化及临床意义.国际检验医学杂志,2013,34(22):3086-3087.
[8]郭楠,陈鹏,徐俊,等.联合检测尿微量蛋白在诊断老年糖尿病肾病中的价值.中国老年学杂志,2013,33(3):1279-1280.
[9]沈永坚,周少雄,黄泽棋,等.尿m ALB和尿NAG酶的联合检测在肾结石中的临床价值.医学检验与临床,2010,21(6):38-39.
[10]王露萍,梁卓寅,梁志雄,等.肾结石患者尿NAG和尿微量白蛋白动态检测及其意义.临床泌尿外科杂志,2005,20(10):617-618.
[2]邓新强,李慧芳,范向平.尿微量蛋白检测对糖尿病早期肾损伤的诊断价值分析.当代医学,2012,18(27):116-117.
[3]陈亮,李建兴,黄晓波,等.肾结石合并肾功能不全患者围手术期尿微量白蛋白与尿肌酐比值检测及意义.北京大学学报(医学版),2011,43(5):757-760.
[4]朱立华.实验诊断学.北京:北京医科大学出版社,2002:309-318.
[5]王露萍,梁卓寅,梁志雄,等.尿NAG、尿微量清蛋白检测在泌尿系结石早期肾损害监测中的临床意义.现代泌尿外科杂志,2005,10(3):134-135.
[6]D’Amico G,Bazzi C.Urinary protein and enzyme excretion as markers of tubular damage.Curr Opin Nephrol Hypertens,2003,12(6):639-643.
[7]彭又生,林绮平,李海涛,等.肾结石患者尿微量蛋白的变化及临床意义.国际检验医学杂志,2013,34(22):3086-3087.
[8]郭楠,陈鹏,徐俊,等.联合检测尿微量蛋白在诊断老年糖尿病肾病中的价值.中国老年学杂志,2013,33(3):1279-1280.
[9]沈永坚,周少雄,黄泽棋,等.尿m ALB和尿NAG酶的联合检测在肾结石中的临床价值.医学检验与临床,2010,21(6):38-39.
[10]王露萍,梁卓寅,梁志雄,等.肾结石患者尿NAG和尿微量白蛋白动态检测及其意义.临床泌尿外科杂志,2005,20(10):617-618.