尿N-乙酰-β-D-氨基葡萄糖苷酶水平测定在慢性肾小球肾炎诊断中的价值评估

目的 研究尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)测定在慢性肾小球肾炎(慢性肾炎)诊断中的价值.方法 研究对象共53例,其中病例组慢性肾炎24例,健康对照组29例.采用6-甲基-2-硫代吡啶-N-乙酰-β-D-氨基葡萄糖苷(MPT-NAG)法分析受试者尿NAG水平,采用免疫透射比浊法分析受试者尿微量清蛋白(UmAlb)含量,采用谷氨酸脱氢酶法检测血清尿素氦(SBUN)浓度；采用肌氨酸氧化酶法测定血清肌酐(SCr)和尿肌酐(UCr)含量.结果 独立样本t检验结果表明,在病例组和健康对照组之间,NAG和UmAlb水平差异有统计学意义(P＜0.05),SBUN和SCr水平差异无统计学意义(P＞0.05)；双变量相关分析显示,NAG与SBUN、SCr、UmAlb的相关系数分别为0.367、0.450和0.824；诊断效果评价表明,NAG、SBUN、SCr和UmAlb水平在ROC曲线下的面积分别为0.728、0.432、0.628和0.888.结论 在实验室建立可靠参考区间的前提下,尿NAG测定可应用于慢性肾炎患者早期肾功能损害的评估.

Diagnostic value of urinary N-acetyl-beta-D-glucosaminidase activity in chronic glomerulonephritis

Objective To investigate the diagnostic value of urinary N-acetyl-beta-D-glucosaminidase（NAG） activity in chronic glomerulonephritis. Methods The subjects included 24 patients with chronic glomerulonephritis and 29 healthy individuals. Urinary NAG was determined by 6 methyl-2-mercaptopyridine -N- acetyl -beta -D- glucosaminide（MPT-NAG） method,urinary microalbumin（UmAlb） was detected by imrnunological transmission turbidimetry method,blood urea nitrogen （BUN） was analyzed by glutamate dehydrogenase method, sarcosine oxidase method was applied to detect serum and urinary creatinine（Cr） levels. Results Between the patient group and health- y control group,significant differences were found in urinary NAG and UmAlb levels（P〈0.05）, there were no statistical differences in BUN and serum Cr levels by t test（P〉0.05）. Between NAG and BUN, serum Cr, UmAlb, the correlation analysis showed the correlation coefficients were 0. 367,0. 450 and 0. 824 respectively. The areas under the ROC curve for NAG,BUN,serum Cr and UmAlb were 0. 728,0. 432,0. 628 and 0. 888 respectively. Conclusion Urinary NAG could be regarded as an ideal index for the diagnosis and surveillance of chronic glomerulonephritis under the condition of reliable reference interval.