2型糖尿病及糖尿病肾病患者视黄醇结合蛋白4检测的意义

目的探讨2型糖尿病(T2DM)及其合并肾病(DN)患者血视黄醇结合蛋白4(RBP4)浓度变化及临床意义。方法根据尿清蛋白排泄率(UAER)将118例T2DM患者分为单纯糖尿病(SDM)组47例、早期糖尿病肾病(EDN)组40例和临床糖尿病肾病(CDN)组31例;另选30例健康体检者作为对照(NC)组。采用酶联免疫吸附试验双抗体夹心法检测RBP4。结果 SDM、EDN、CDN组RBP4、超敏C-反应蛋白(hs-CRP)较NC组升高(P<0.05),随病情加重,升高更为明显。RBP4与hs-CRP高度相关(r=0.77,P<0.01)。T2DM患者血浆RBP4水平随着尿清蛋白的增加而升高。结论 T2DM患者血浆RBP4水平明显升高,可作为DN早期的敏感的诊断指标。     

先兆子痫患者血清视黄醇结合蛋白4的表达水平

目的 检测先兆子痫患者血清视黄醇结合蛋白4（RBP4）和超敏C反应蛋白（hsCRP）的水平,探讨RBP4与先兆子痫发病的关系.方法 采取先兆子痫组61例（轻度先兆子痫组31例、重度先兆子痫组30例）,正常妊娠组30例,非孕对照组30例,采用酶联免疫吸附试验等法测定其血清中RBP4和hsCRP浓度,同时测定胰岛素抵抗指数和血脂.结果 轻度和重度先兆子痫组血清RBP4均明显高于正常妊娠组和非孕对照组,差异均有统计学意义（q分别=2.24、2.46、2.61、2.83,P均＜0.05）,hsCRP水平明显高于正常妊娠组和非孕对照组,差异均有统计学意义（q分别=2.15、2.21、2.43、2.55,P均＜0.05）;重度先兆子痫组RBP4和hsCRP均明显高于轻度先兆子痫组,差异均有统计学意义（q分别=3.25、3.17,P均＜0.05）;先兆子痫孕妇血清RBP4水平与血清hsCRP和HOMA-IR呈正相关（r分别=0.42,0.38,P均＜0.05）.结论 先兆子痫患者血清RBP4水平升高,可作为临床观察指标.     

血清视黄醇结合蛋白在肾病早期诊断中的应用

目的探讨血清视黄醇结合蛋白(RBP)在高血压肾病早期诊断中的应用价值。方法采用免疫透射比浊法和速率法检测65例肾病患者血清RBP、尿素(Urea)、肌酐(Cr),同时检测53例健康体检者作为对照。结果与对照组相比,肾病患者各组血清中RBP、Urea、Cr含量均有不同程度升高,其中RBP含量升高最为显著。结论血清RBP水平反映肾小球的滤过功能,可以作为肾病早期诊断的较敏感指标。     

血清视黄醇结合蛋白检测对2型糖尿病患者早期肾功能损伤诊断的价值

目的应用受试者工作特征(ROC)曲线评价血清视黄醇结合蛋白(RBP)检测在2型糖尿病(T2DM)早期肾功能损伤中的应用价值。方法将155例临床确诊为T2DM的患者按照尿微量清蛋白(mAlb)/尿肌酐(UCr)比值分为单纯糖尿病组、早期糖尿病肾病组和临床糖尿病肾病组;另外选取同一时期进行健康体检且合格者作为对照组;比较各组间的差异,同时通过ROC曲线评价RBP在糖尿病早期肾功能损伤中的诊断价值。结果早期糖尿病肾病组与对照组、单纯糖尿病组比较,RBP水平差异均有统计学意义(P0.05);血清RBP的ROC曲线下面积为0.770,灵敏度和特异度分别为81.0%、95.2%。结论 RBP检测有助于发现糖尿病患者早期肾功能损伤。     

3种视黄醇结合蛋白生化试剂的比较和评价

目的了解3种视黄醇结合蛋白(RBP)生化试剂(A,B,C)在同一台生化分析仪上的检测结果是否具有可比性。方法先检测仪器及视黄醇结合蛋白(RBP)生化试剂重复性,再以B试剂为比较试剂,其他两种为试验试剂,对49例测定结果进行相关分析。然后用RBP试剂分别测定自身及其他厂家的两种试剂质控品,与靶值比较计算相对偏差。结果 3种RBP生化试剂(A,B,C)测定同一份混合血清的变异系数分别为0.87%、1.15%、2.90%。3种生化试剂新鲜血清RBP测定结果相关系数(A,C与B比较)分别为0.962 1、0.972 6。3种生化试剂测定质控品,与靶值比较计算相对偏差分别为:A试剂(-40.38%～3.26%);B试剂(-8.75%～18.14%);C试剂(28.38%～67.78%)。结论 A、B、C试剂精密度都较好,但B试剂与其他试剂比较测定质控品的相对偏差较小,因此总体显示B试剂性能指标优于其他两种试剂。     

血清视黄醇结合蛋白4在糖尿病肾病早期诊断中的临床价值

目的探讨血清视黄醇结合蛋白4(RBP4)在糖尿病早期肾功能损伤方面的临床诊断价值。方法根据尿清蛋白排泄率将确诊的232例糖尿病患者分为早期糖尿病肾病(DN)组、临床期DN组,治疗期DN组,单纯DN组,与60例健康对照者同时检测血清RBP4、胱抑素C(Cys-C)、尿素氮(BUN)、肌酐(Cr),并进行统计学处理(t检验和χ2检验)。结果早期DN组RBP4水平明显高于单纯DN组,差异具有统计学意义(t=6.704 3,P<0.01),与同期Cys-C检测结果呈正相关。而BUN、Cr检测结果与单纯DN组比较,差异无统计学意义(P>0.05)。早期DN组RBP4灵敏度比Cys-C、BUN和Cr指标的灵敏度高,RBP4阳性率早期DN组(62.1%)显著高于治疗期DN组(27.6%)(χ2=13.942 3,P<0.01)。结论血清RBP4是一种良好的检测早期肾功能损害的标志物,可作为糖尿病肾病早期诊治及疗效判断的定期筛选及监测指标。     

血清视黄醇结合蛋白与维持性血液透析终末期肾病患者心血管事件的关系

目的:探究血清视黄醇结合蛋白(retinol binding protein,RBP)与维持性血液透析(maintenance hemodialysis,MHD)终末期肾病患者发生心血管事件的关系。方法:回顾性分析2017年3月至2020年3月于海南医学院第二附属医院行MHD治疗的100例终末期肾病患者的临床资料,收集所有患者一般资料与入院后24h内血清RBP水平,根据治疗期间是否发生心血管事件将患者分为事件组(n=41)和非事件组(n=59)。采用单因素及logistic回归模型分析相关指标与MHD终末期肾病患者发生心血管事件的关系,并采用受试者工作特征(receiver operating characteristic curve,ROC)曲线分析RBP对MHD终末期肾病患者发生心血管事件的评估价值。结果:与非事件组相比,事件组年龄明显更大,透析时间更长,三酰甘油(triglyceride,TG)、肌钙蛋白(Troponin,cTnT)、C反应蛋白(C-reactive protein,CRP)、血肌酐(serum creatinine,SCr)、免疫反应性甲状旁腺素(immunoreactive parathyroid hormone,iPTH)及RBP水平均明显更高(P<0.05)。Logistic回归分析显示:年龄(OR=1.369)、透析时间(OR=1.595)、cTnT(OR=1.082)、CRP(OR=1.059)及RBP(OR=2.793)均是MHD终末期肾病患者发生心血管事件的独立危险因素(P<0.05)。ROC曲线分析显示:血清RBP水平预测MHD终末期肾病患者发生心血管事件的曲线下面积为0.769(95%CI:0.662~0.855),敏感度为75.61%,特异度为70.73%,最佳截断值为178.08mg/L。结论:高水平RBP是MHD终末期肾病患者发生心血管事件的独立危险因素,对MHD终末期肾病患者发生心血管事件具有重要预测价值。     

Demonstration in serum of two physiological forms of the human retinol binding protein

Abstract. The contents of prealbumin, retinol binding protein, and retinol in normal human serum have been estimated. The amounts of prealbumin were, on average, 6 times larger than those of RBP, that is a two-fold molar excess of prealbumin over RBP. Retinol and RBP were present in about the same molar amounts. Prealbumin occurred in two molecular forms in serum. About half of the prealbumin was bound to RBP (prealbumin-RBP complex) and half was in free form. In spite of the molar excess of prealbumin, small amounts of free RBP were encountered. The free RBP was isolated from normal serum and displayed about the same characteristics as RBP isolated from the prealbumin-RBP complex. Some significant differences were noted however. The free RBP had a lower content of retinol and one amino acid residue less of arginine. The contents of prealbumin, RBP, and retinol were also estimated in the sera of patients subjected to chronic haemodialysis. The amounts of prealbumin and retinol were normal or somewhat low whereas the values for RBP were considerably elevated. The size distribution of RBP and retinol in the serum of one of these patients showed that the amount of free RBP was considerably elevated whereas the amount of the prealbumin-RBP complex was normal. Retinol was apparently associated only with the prealbumin-RBP complex. Various analyses revealed that RBP, isolated in free form from serum, did not bind to prealbumin in contrast to RBP from the prealbumin-RBP complex. It is suggested that the free species of RBP, present in serum, represents a transitory form which has fulfilled its physiological role and will rapidly be degraded by the kidney.     

血清胱抑素C和视黄醇结合蛋白检测在肿瘤诊断的价值

目的通过对肿瘤患者血清中胱抑素C(Cys C)和视黄醇结合蛋白的浓度检测,探讨Cys C和视黄醇结合蛋白在肿瘤患者肾功能损害诊断中的临床意义。方法采用胶乳增强免疫比浊法在奥林巴斯AU480全自动生化分析仪上分别检测血清样本中Cys C和视黄醇结合蛋白的浓度。结果肿瘤患者血清样本中Cys C和视黄醇结合蛋白的浓度明显高于对照组,两者比较差异有统计学意义(P<0.05)。肿瘤患者血清Cys C和视黄醇结合蛋白的阳性检测率均在65.0%左右。结论血清Cys C和视黄醇结合蛋白的浓度检测可优先作为诊断肿瘤患者肾功能损害程度的检测指标,其浓度变化对肿瘤患者肾损害病情监测的具有重要意义。     

血清视黄醇结合蛋白和胱抑素C在2型糖尿病早期肾功能损害中的应用

目的：应用受试者特征工作曲线（ROC曲线）评价血清视黄醇结合蛋白（RBP）和胱抑素C（Cys C）在2型糖尿病（T2DM ）早期肾功能损害中的临床价值。方法选择2013年7月至2014年5月泸州医学院附属医院门诊或住院部确诊的 T2DM 患者155例为研究对象,根据尿微量清蛋白/尿肌酐比值将患者分为单纯糖尿病（SDM ）组、早期糖尿病肾病（EDN ）组和临床糖尿病肾病（CDN ）组;另选同一时期健康体检者为健康对照组。采用胶体金增强免疫法和免疫比浊法分别检测RBP和Cys C ,通过ROC曲线评价其对糖尿病早期肾功能损害的价值。结果随着病情进展血清RBP、Cys C水平逐渐增高,EDN组Cys C、RBP水平与健康对照组、SDM 组对比,差异均有统计学意义（P＜0．05）,且与尿微量清蛋白/肌酐有较好相关性。血清 RBP、Cys C的 ROC曲线下面积分别为0．770、0．868,最佳截点值分别为40．95 mmol/L、1．055 mmol/L ,灵敏性和特异性分别为81．0％、93．7％和95．2％、78．1％。结论 RBP和Cys C是检测早期肾功能损害的良好标志物,Cys C的诊断效果优于RBP ,联合检测可提高早期糖尿病肾功能损害的诊断效率。     

Association between urine retinol‐binding protein levels and nonalcoholic fatty liver disease: A cross‐sectional study in Chinese population

Objective

The prevalence of nonalcoholic fatty liver disease (NAFLD) has been rapidly increased, becoming a public health problem worldwide. Our objective was to investigate the association between urine retinol‐binding protein (RBP) and NAFLD in a Chinese population and develop a multivariate logistic regression model for NAFLD prediction.

Methods

A total of 317 NAFLD patients and 391 healthy controls were enrolled in this cross‐sectional study based on inclusion and exclusion criteria, from whom fasting urine and blood were collected for further study. Urine RBP level and other parameters were measured and compared between NAFLD subjects and controls.

Results

Urine RBP levels (expressed by RBP/creatinine ratio) in NAFLD patients were significantly higher than controls (median 133.1 mg/g vs 110.7 mg/g; P < .001). Urine RBP/creatinine ratio was verified as an independent factor for NAFLD prediction after adjustment in multivariate logistic regression. The area under curve (AUC) of receiver operating characteristic (ROC) was 0.889 with the 95% confidence interval from 0.867 to 0.912.With a cutoff point of 0.215, the sensitivity and specificity of urine RBP/creatinine ratio in NAFLD prediction were 81.1% and 84.5%, respectively.

Conclusion

Our results demonstrated that urine RBP/creatinine ratio was an independent risk factor for NAFLD while the predictive model for NAFLD diagnosis is noninvasive with high sensitivity and specificity.

     

肾综合征出血热患者血清视黄醇结合蛋白和胱抑素C水平及其与肾损伤的相关性分析

目的 探讨肾综合征出血热患者血清视黄醇结合蛋白(RBP)和胱抑素C(CysC)水平及其与肾损伤的相关性.方法 选取肾综合征出血热患者150例作为实验组.选择体检健康者150例作为对照组.对比2组RBP、CysC、尿素及肌酐水平;分析实验组在不同时期RBP、CysC、尿素及肌酐检测阳性率;分析RBP、CysC与尿素及肌酐相关性;分析RBP与CysC单项检测及联合检测的阳性率.结果 与对照组相比,实验组在发热期RBP、CysC、尿素及肌酐水平显著升高(P<0.05).实验组在低血压休克期、少尿期及多尿期4项指标检测阳性率最高.RBP、CysC与尿素及肌酐均呈正相关(r=0.76、0.81、0.89、0.84,P<0.05).联合检测在不同时期的检测阳性率均显著高于单一检测(P<0.05).结论 RBP、CysC均与尿素及肌酐呈正相关,且联合检测具有较高的诊断符合率.     

470例小儿肾脏疾病尿视黄醇结合蛋白测定

目的 探讨各型肾脏疾病患儿肾小管受累情况以及建立小儿尿视黄醇结合蛋白（RBP）正常值。方法 应用酶联免疫吸附试验（ELISA测定各型肾脏疾病小儿尿RBP的含理。结果 以单侧95%百分位数确定尿RBP小儿正常对照组的上限值为13.45μg/mmolCr;各病组阳性百分值（大于正常组95%百分位数的例数与该组总病例数之比）以急性肾衰,慢性肾衰和糖尿病（100%）3组最高;其他依次为肝豆状核变性（88.89%) ,乙型肝炎相关性肾炎（78.57%),狼疮性肾炎（76.92%),肾病综合征（64.08%),病毒性肾炎（60.00%)、IgA肾炎（58.82%),过敏性紫瘢肾炎（47.19%),遗传性肾炎（33.33%),急性肾小球肾炎（28.00%)和肾炎综合征（22.64%)组;以单纯性血尿组（15.00%)最低。结论 尿RBP含量升高提示患儿肾脏受损部位为肾小管;各型肾脏疾病尿RBP测定值大小显示肾小管受损程度。     

Prognostic value of prealbumin,N-terminal pro-B-type natriuretic peptide,heart type fatty acid binding protein,and cardiac troponin I in elderly patients for heart failure and poor outcomes

ObjectivesThis study aimed to investigate the prognostic value of serum prealbumin, N-terminal pro-B-type natriuretic peptide (NT-proBNP), heart type fatty acid binding protein (hFABP), and cardiac troponin I (cTnI) for heart failure and cardiac death in elderly patients.MethodsWe studied 426 consecutive patients with New York Heart Association classes I to IV who were recruited between February 2014 and 2018. Cardiac mortality was the primary end point. Receiver operator characteristic curves were created to analyze predictive values.ResultsWhen prealbumin, NT-proBNP, hFABP, and cTnI were combined, the areas under the receiver operator characteristic curve reached 0.930 and 0.903 for heart failure and cardiac death, respectively. Prealbumin, NT-proBNP, hFABP, and cTnI levels changed differently during therapy in patients in different prognosis groups. These parameters improved in patients who did not develop major adverse cardiovascular events (MACEs), but were unchanged or deteriorated in patients with MACEs. Multivariate Cox regression analysis showed that these parameters were significant independent risk factors for MACEs and cardiac death.ConclusionsOur study shows that serum prealbumin, NT-proBNP, hFABP, and cTnI levels are significant prognostic factors for elderly patients with poor cardiac function. These parameters are more accurate for prognosis when used together.     

联合检测尿微量白蛋白、转铁蛋白和αl-微球蛋白在窒息新生儿早期肾损伤的应用价值

目的 探讨窒息新生儿尿微量白蛋白(MA)、αl-微球蛋白(α1M)和转铁蛋白(TRU)水平的变化及对新生儿早期肾损伤的诊断价值.方法 取87例窒息新生儿(轻度窒息53例,重度窒息34例)及40例无窒息及严重感染性疾病的同期住院新生儿生后24 h尿液作MA、αlM、TRU检测;同时抽取静脉血检测血肌酐(Cr)、尿素氮(BUN).结果 窒息组尿MA、αlM、TRU及血Cr浓度异常率均较对照组明显升高,而重度窒息组尿MA、αlM、TRU及血Cr浓度异常率则较轻度组明显升高,均有极显著性差异(P<0.01),但血BUN浓度在各组间比较差异均无统计学意义(P>0.05).结论 尿MA、αlM、TRU升高与新生儿窒息程度及肾损伤密切相关,是窒息新生儿早期肾功能损伤监测的灵敏、有效的指标.     

小切口甲状腺切除术治疗甲状腺腺瘤对前白蛋白、视黄醇结合蛋白和C反应蛋白的影响

目的观察小切口甲状腺切除术和传统甲状腺切除术治疗甲状腺腺瘤的疗效及其对前白蛋白(PA)、视黄醇结合蛋白(RBP)和C反应蛋白(CRP)的影响。方法选择2011年6月至2013年12月就诊的甲状腺腺腺瘤患者126例。根据手术的切口大小不同,分为小切口组(66例)和传统组(60例)。观察两组术中出血量、手术时间、术后住院时间、术后引流量和并发症的情况;观察两组治疗前后PA、RBP和CRP水平的变化。结果小切口组的术中出血量、手术时间、术后住院时间、术后引流量和并发症较传统组减少或者降低,差异有统计学意义(P0.05或P0.01)。治疗后两组的PA和RBP水平均较治疗前明显降低(P0.01),传统组的降低水平较小,切口组更为明显(P0.01),而CRP水平治疗后较治疗前明显升高(P0.01),传统组的升高水平更为明显(P0.01)。结论小切口甲状腺切除术治疗甲状腺腺瘤疗效确切,创伤较小,术后恢复快等优点,值得临床推广。     

Determination of five protein analytes using the beckman array™ and the behring nephelometer system

The Beckman Array and the Behring Nephelometer offer the clinical laboratory completely automated discrete protein analysis. To select one of these systems, we compared five protein analytes: IgG, IgA, IgM, transferrin, and prealbumin. In addition to automation, we wanted to achieve better precision than our present method and have available a wider range of test selection. The Beckman Array gave 2-week stability of calibration, analyzed lipemic samples without significant problems, and had direct manufacturer's service available. The Behring Nephelo meter offered a choice of single or multipoint calibration, retrieval of raw data, ease of operation, more flexibility in test parameters, and choice of calibrator. Interference from lipemia frequently caused variable results requiring pretreatment of the sample. Both instruments demonstrated excellent precision, linearity, and correlated adequately with the Hyland Laser Nephelometer PDQ. The Array demonstrated slightly better slope values than those of the Behring Nephelometer with the exception of prealbumin analysis.     

随机尿蛋白与血清胱抑素C比值与24h尿蛋白定量的相关性研究

目的 研究随机尿蛋白，血清胱抑素C比值与24h尿蛋白定量的相关性。方法 对74例不同肾脏疾病和不同程度肾功能的患者进行24h尿蛋白定量和随机尿蛋白，血清胱抑素C比值、随机尿蛋白，尿肌酐比值、随机尿蛋白，尿渗透压比值的相关分析。结果 随机尿蛋白，血清胱抑素C比值、随机尿蛋白，尿肌酐比值、随机尿蛋白，尿渗透压比值与24h尿蛋白定量具有高度相关，相关系数分别为0．786（P〈0．01）、0．698（P〈0．05）、0．723（P〈0．01）。结论 随机尿蛋白，血清胱抑隶C比值可替代24h尿蛋白定量。     

妊娠相关蛋白 A、尿转铁蛋白、D-二聚体在妊娠期高血压病患者中的变化

目的：观察妊娠相关蛋白 A(PAPP-A)、尿转铁蛋白、D-二聚体在妊娠期高血压疾病患者检测中的意义及其相关性分析。方法选择在我院就诊的妊娠期高血压疾病患者120例,为妊娠期高血压疾病组,选择同期足月妊娠的健康孕妇30例,为正常妊娠组,选择健康体检的非孕期妇女20例,为健康对照组。观察3组的 PAPP-A,尿转铁蛋白和 D-二聚体水平及与妊娠期高血压疾病严重程度的关系及其相互关系。结果 PAPP-A、尿转铁蛋白和 D-二聚体水平在妊娠期高血压疾病组明显高于正常妊娠组和健康对照组(P <0.01),而正常妊娠组明显高于健康对照组(P <0.01)。PAPP-A、尿转铁蛋白和 D-二聚体水平随着妊娠期高血压疾病严重程度升高而升高(P <0.01)。妊娠期高血压疾病患者的 PAPP-A 水平与尿转铁蛋白(r =0.593,P <0.01)和 D-二聚体(r =0.692,P <0.01)呈正相关,而 D-二聚体与尿转铁蛋白呈正相关(r =0.622,P <0.01)。结论妊娠相关蛋白 A,尿转铁蛋白,D-二聚体水平的异常与妊娠期高血压疾病的严重程度有关,为早期诊断和治疗妊娠期高血压疾病提供了依据。