高血压病患者尿微量白蛋白、β2-MG、NAG检测的临床意义

目的探讨尿微量白蛋白(MA)、β2-微球蛋白(β2-MG)、N-乙酰β-D-葡萄糖苷酶(NAG)对高血压肾病早期诊断和预防的意义。方法对180例高血压病患者尿液进行MA、β2-MG、NAG测定并分3组比较。结果高血压病患者40~49岁组尿MA(12.2±7.2)mg/L、β2-MG(4.5±2.1)mg/L、NAG(1.9±0.81)U/mmol;50~59岁组MA(19.5±12.2)mg/L、β2-MG(9.8±4.8)mg/L、NAG(2.6±1.1)U/mmol;60~70岁组MA(25.5±15.5)mg/L、β2-MG(15.4±10.5)mg/L、NAG(3.8±2.4)U/mmol,均明显高于健康对照组(P<0.01),且阳性率有增高的趋势。结论尿MA、β2-MG、NAG可作为高血压病患者肾损伤早期诊断指标,建议这些项目应该列为高血压病患者常规检查,以便早期发现肾损伤。     

尿蛋白四项测定对过敏性紫癜早期肾损害的临床意义

目的 探讨尿蛋白测定在小儿过敏性紫癜早期肾损害中的诊断意义.方法 42例过敏性紫癜患儿(观察组)和38名体检健康儿童(对照组),采用免疫散射比浊法进行尿免疫球蛋白G(IgG)、尿微量白蛋白(MA)、尿α_1-微球蛋白(α_1-MG)、尿转铁蛋白(TRF)的测定,同时测定尿常规和尿素氮(BUN)、肌酐(SCr)水平.结果 观察组患儿肾功能均正常,尿四项指标[IgG为(11.57±6.44)mg/L、MA为(21.10±8.23)mg/L、α_1-MG为(23.40±6.21)mg/L、TRF为(9.13±1.60)mg/L]均明显高于对照组[IgG为(5.78±2.93)mg/L、MA为(10.37±4.25)mg/L、α_1-MG为(7.23±3.49)mg/L、TRF为(0.74±0.25)mg/L],2组比较,差异有统计学意义(P均<0.05);42例患儿四项指标异常率为73.8%(31/42),尿常规异常率为14.3%(6/42).结论 尿蛋白四项的检测是诊断小儿过敏性紫癜早期肾损害的灵敏指标,是早期发现过敏性紫癜肾损害的无创性检验的可靠而简单的方法.     

尿蛋白分析在肾脏疾病中的临床价值

目的探讨尿蛋白分析[尿α_1-微球蛋白(α_1-MG)、β_2-微球蛋白(β_2-MG)、微量白蛋白(MA)、尿总蛋白(UTP)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)]对于诊断早期肾损伤的临床价值。方法收集病理上无明显肾小球、肾小管病变且尿常规检查正常但可能存在早期肾损伤的高血压病、糖尿病患者的尿液标本80例,同期收集健康体检尿液标本80例为健康对照组。检测各组α_1-MG、β_2-MG、MA、UTP、NAG的含量,并对结果进行统计学分析。结果当出现早期肾损伤(如高血压、糖尿病)尿α_1-MG、β_2-MG、MA、UTP、NAG均有不同程度的升高,5项检测指标之间具有较好的相关性,且与健康对照组相比差异具有统计学意义[α_1-MG(mg/L):19.7±1.4比5.3±1.6,β_2-MG(mg/L):10.8±0.04比1.2±0.03,MA(mg/L):56.3±6.7比8.6±4.2,UTP(g/L):0.395±0.097比0.069±0.028,NAG(U/L):78.4±7.6比17.9±5.1,均P0.01]。结论对尿α_1-MG、β_2-MG、MA、UTP、NAG进行联合检测可以为肾脏早期损伤的诊断提供灵敏可靠的指标,从而帮助临床诊断早期肾损伤并及时干预,提高患者的治愈率。     

尿胱抑素C检测对2型糖尿病肾小管早期损伤的应用价值

目的探讨尿胱抑素C(CysC)浓度在2型糖尿病患者肾小管早期损伤中的临床应用价值。方法用透射免疫比浊法测定尿CysC;连续监测比色法测定尿N-乙酰-β-氨基葡萄糖苷酶(NAG);免疫比浊法测定尿β2微球蛋白(β2-MG)。结果 24h尿清蛋白排泄率(UAER)<30mg的DM1组患者尿CysC、NAG、β2-MG与正常对照组尿CysC(0.08±0.04)mg/L、NAG(10.8±8.6)U/L、β2-MG(0.10±0.08)mg/L比较差异有统计学意义(P<0.05);24h尿UAER在30～300mg时,尿CysC、NAG、β2-MG均显著增高(P<0.01)。结论在糖尿病肾病早期,尿CysC、NAG、β2-MG的浓度均升高,尿CysC显著升高,尿CysC可以作为糖尿病早期肾小管损伤的评价指标。     

尿mAlb、尿NAG及尿γ-GGT对接铅作业人员早期肾损伤的探讨

目的探讨生化指标改变与接铅作业人员早期肾损伤的关系。方法收集187例接铅作业人员及110例健康对照者清晨尿液,分别作尿铅、尿微量清蛋白(mAlb)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、尿γ-谷氨酰转移酶(γ-GGT)测定。结果 110例健康对照:尿mAlb为(20.6±3.2)μg/mg、尿NAG为(10.1±1.0)U/L、尿γ-GGT为(35±4.07)U/L。187例接铅作业人员中,41例尿铅水平高于正常参考值,即尿铅阳性组;146例尿铅水平在正常参考值以内,即尿铅阴性组。尿铅阳性组:尿mAlb为(26.3±4.31)μg/mg、尿NAG为(12.25±1.3)U/L、尿γ-GGT为(61.0±6.82)U/L;尿铅阴性组:尿mAlb为(25.8±4.2)μg/mg、尿NAG为(12.0±1.1)U/L、尿γ-GGT为(60.0±6.5)U/L,两组差异无统计学意义(P>0.05)。结论在高铅环境中工作的人员,存在早期肾损伤的可能性。     

尿NAG、β2-MG变化与儿童过敏性紫癜肾炎肾功能损害的关系

目的探讨过敏性紫癜性肾炎患儿尿N-乙酰-β-氨基葡萄糖苷酶(NAG)、β2微球蛋白(β2-MG)的水平变化及其意义。方法选取我院2016年3月-2017年10月收治的160例过敏性紫癜性肾炎患儿,根据尿蛋白水平分为A组(孤立性血尿)56例、B组(轻度蛋白尿)43例、C组(中度蛋白尿)32例、D组(肾病水平蛋白尿)29例。对比四组患儿尿NAG、β2-MG水平,分析过敏性紫癜性肾炎患儿尿NAG、β2-MG水平与血清尿素氮(BUN)、肌酐(Cr)的关系。结果(1)4组研究对象尿NAG、β2-MG水平比较差异有统计学意义(P0.01),D组尿NAG、β2-MG水平显著高于A组、B组、C组(P0.05),C组尿NAG、β2-MG水平显著高于A组、B组(P0.05),B组尿NAG、β2-MG水平显著高于A组(P0.05)。(2)4组研究对象血清BUN、Cr水平比较差异有统计学意义(P0.01),D组血清BUN、Cr水平显著高于A、B、C三组,差异均具有统计学意义(P0.05)。(3)过敏性紫癜性肾炎患儿尿NAG、β2-MG水平与血清BUN、Cr水平呈显著正相关系(P0.01)。结论过敏性紫癜性肾炎患儿尿NAG、β2-MG水平与肾功能损害程度具有一定的相关性。     

肝素对紫癜性肾炎患儿早期尿转铁蛋白、微量清蛋白及β2微球蛋白的影响

目的：探讨肝素对紫癜性肾炎（HSPN）患儿早期尿转铁蛋白（TRF）、尿微量清蛋白（MA）及β2-微球蛋白（β2-MG）的影响。方法：用放射免疫法检测尿TRF、MA和β2-MG,比较HSPN 35例肝素组和31例对照组治疗前后TRF、MA、β2-MG变化。结果：治疗后肝素组TRF、MA、β2-MG较对照组均明显降低。结论：肝素能降低HSPN患儿早期尿TRF、MA及β2-MG水平,对HSPN有治疗作用。     

尿液微量蛋白4项检测对糖尿病肾病的早期诊断价值

目的探讨尿微量白蛋白(MA)、尿转铁蛋白(TRF)、α_1-微球蛋白(α_1-MG)及β_2-微球蛋白(β_2-MG)的定量检测对糖尿病肾病(DN)的早期诊断价值。方法根据尿蛋白定性试验将65例2型糖尿病患者分为尿蛋白定性阳性组和阴性组,采用免疫比浊法定量检测65例2型糖尿病患者及30例健康体检人员的MA、TRF、α_1-MG及β_2-MG水平,并对结果进行统计和分析。结果尿蛋白定性阳性组和尿蛋白定性阴性组患者的MA(mg/L:28.6±4.4、11.3±1.9比6.9±1.1)、TRF(mg/L:3.5±0.9、1.3±0.4比1.1±0.3)、α_1-MG(mg/L:28.1±6.3、9.4±2.0比8.2±1.9)及β_2-MG(mg/L:4.77±0.71、1.58±0.39比0.94±0.22)均明显高于正常对照组,且尿蛋白阳性组的这4项微量蛋白水平又明显高于尿蛋白阴性组,差异均有统计学意义(均P0.05);MA、TRF、α_1-MG及β_2-MG单项检测对2型糖尿病患者诊断的阳性率分别为41.5%、44.6%、38.5%及33.8%,联合检测这4项微量蛋白的阳性率可高达90.5%。结论尿MA、TRF、α_1-MG及β_2-MG是DN的早期诊断的敏感指标,联合检测这4项指标对提高DN的早期诊断以及鉴别其病变部位有重要意义。     

尿N-乙酰-β-D-氨基葡萄糖苷酶在脓毒症并发早期肾功能损害中的诊断价值

目的 探讨尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)在脓毒症患者并发早期肾功能损害中的诊断价值.方法 上海中医药大学附属岳阳医院收治的脓毒症患者124例,住院后即刻测定尿NAG、血清肌酐(SCr)、尿素氮、血β2-微球蛋白(β2-MG)、尿β2-MG;住院第3天复查上述指标,根据第3天SCr和(或)尿素氮分为肾功能损害组(n=44)和肾功能正常组(n=80).结果 入院时两组患者尿NAG比较差异有统计学意义(P＜0.05),SCr、尿素氮和血、尿β2-MG比较差异均无统计学意义(P＞0.05);入院第3天两组患者尿NAG、SCr、尿素氮和血、尿β2-MG比较,差异均有统计学意义(P＜0.05或＜0.01),肾功能损害组和肾功能正常组尿NAG、SCr、尿素氮和血、尿β2-MG,分别为(20.41±11.57) U/L vs (12.90±6.33) U/L、(142.14±26.32) μmol/L vs (103.00±11.53) μmol/L、(6.37±3.41) mmol/L vs (5.21±1.68) mmol/L、(6.11±2.59) μg/L vs (5.02±1.87) μg/L、(263.74±142.87)μg/L vs (182.42±91.27) μg/L;尿NAG水平与SCr水平呈正相关(r=0.201,P＜0.05).结论 尿NAG水平对诊断脓毒症患者并发早期肾功能损害具有重要的诊断价值.     

3项指标联合检测对糖尿病肾病的早期诊断价值

目的探讨联合检测尿转铁蛋白(TRF)、N-乙烯-β-D-氨基葡萄糖苷酶(NAG)及血半胱氨酸蛋白酶抑制剂C(Cys C)对糖尿病肾病的早期诊断价值。方法用免疫比浊法检测尿TRF和血Cys C,终点法检测尿NAG,并比较其在各组中的差异。结果 TRF、NAG及血Cys C在糖尿病无蛋白尿组(A组)中的浓度分别为(3.12±0.45)mg/L(、2.26±0.97)U/mmoL和(1.83±0.37)mg/L,糖尿病蛋白尿组(B组)中的浓度分别为(10.66±3.50)mg/L(、4.30±1.74)U/mmoL和(3.14±0.96)mg/L,A组中各指标的浓度均显著高于健康对照组中相应的浓度,B组中各指标的浓度均显著高于A组中相应的浓度(P<0.05)。单纯检测一项或两项指标阳性率较低,而联合检测则能提高阳性率。结论联合检测尿TRF、NAG及血Cys C能反映糖尿病肾病的早期损害,对糖尿病的早诊断、早治疗有重要的临床价值。     

Calcium oxalate crystallization in untreated urine, centrifuged and filtered urine and ultrafiltered urine.

Centrifuged and filtered urine is often used to evaluate in vitro the crystallization processes of calcium oxalate (CaOx), but even such simple manipulations can alter the composition of the urine, as regards its protein and lipid concentrations. In urine samples taken from 17 normal male adults, we evaluated CaOx crystallization by simultaneously using three different types of urine: untreated (U), centrifuged at 2000 rpm (800 g) and filtered at 0.22 microm (CF), and centrifuged-filtered and ultrafiltered at 10 000 Da (CFU). The addition of 1.2 mmol/l of oxalate to each type of urine produced notably different results. The total amount of CaOx crystals (expressed as calcium oxalate dihydrate crystals (COD) + oxalate monohydrate crystals (COM) area/total area x 100) was on average 13.2% in U urine, 70.7% in CF urine and 11.1% in CFU urine (CF > U and CFU, U = CFU); the relative prevalence of COD and COM (expressed as COD area/COM area) was on average 71.4 in U urine, 0.0026 in CF urine and 5.5 in CFU urine (U > CF and CFU, CFU > CF); the diameter of COD (expressed in microns) was on average 15.2 in U urine, 3.7 in CF urine and 24.3 in CFU urine (CFU > U and CF, U > CF); the diameter of COM (expressed in microns) was on average 5.2 in U urine, 2.6 in CF urine and 8.9 in CFU urine (CFU > U and CF, U > CF); the total amount of CaOx aggregates (expressed as CaOxAgg area/total area x 100) was on average 8.5% in U urine, 22.1% in CF urine and 2.9% in CFU urine (CF > U and CFU, U > CF). We conclude that CaOx crystallization processes in manipulated urine are extremely different, probably due to changes in macromolecular compounds.     

尿沉渣定量分析仪与尿干化学分析仪在尿液细胞检测中的联合应用

目的评价IQ200全自动尿沉渣定量分析仪(以下简称IQ200)、Mejer700尿干化学分析仪(以下简称Mejer700)检测尿液中红细胞(RBC)和白细胞(WBC)的效能。方法分别采用IQ200、Mejer700及尿沉渣离心镜检3种方法检测1 000例患者尿液标本中的RBC和WBC,以尿沉渣离心镜检法为金标准,分析IQ200与Mejer700对尿液中RBC和WBC检测的灵敏度、特异度和准确度。结果 3种方法检测尿液中RBC和WBC的阳性率差异均无统计学意义(P0.05)。IQ200与Mejer700结合使用,能大大提高对RBC和WBC检测的灵敏度。结论 IQ200、Mejer700两种方法灵敏度度较高,联合应用具有较高的准确度和灵敏度,能提高工作效率,建议3种方法联用以减少检验误差,提高尿液分析质量。     

Ethylamine in human urine

The urinary excretion of ethylamine has been measured in 200 unrelated healthy volunteers (100 male, 100 female) who maintained their normal diet. The average daily output was 7.82+/-7.03 mg (mean+/-S.D.) (8.01+/-7.40 male; 7.64+/-6.67 female) with a range of values spreading from 0.22 to 35.27 mg. Dietary studies investigating 41 food substances did not highlight any major sources of this amine, except that drinking tea increased subsequent urinary ethylamine levels.     

Methylamine in human urine

The aim of the present study is to evaluate the biochemical parameters in blood relevant to oxygen free radicals and antioxidant defenses in children with asthma. A total of 210 asthmatic children, aged 5-18 years, were studied at two different times, once during a severe episode of wheeze (during episode category) and the other after recovery (resting condition). A total of 180 healthy children participated in the study as age and sex matched healthy controls. Superoxide and hydroxyl radical assays were used as a measure of free radical formation. Antioxidant enzymes and free radical scavengers in blood were also assayed. Lipid peroxidation products were assayed in plasma and erythrocytes to evaluate the imbalance (if any) between oxidant (radical) formation and their inactivation. Serum IgE concentrations and peak expiratory flow rate (PEFR) were used as measures of allergic reactions and residual lung capacity, respectively. Excessive production of superoxide and hydroxyl radicals were noted in the blood cells in asthmatics and were correlated to the severity of disease measured as PEFR. Superoxide dismutase and free radical scavengers in blood were significantly lower in asthma, even during resting condition. The present observations endorse the correlation between disease severity and oxygen radical production in asthma subjects. Oxygen metabolites may play a direct or indirect role in the modulation of airway inflammation. Excessive superoxide and hydroxyl radical production may be used as a marker for susceptibility to asthma and for monitoring therapeutic measures.