糖尿病尿五种微量蛋白检测评估早期肾损害

目的：探讨尿五种微量蛋白测定在糖尿病肾病（ＤＮ）早期诊断中的诊断价值。方法：采用放射免疫分析法（ＲＩＡ）检测３０例正常人及９８例非胰岛素依赖性糖尿病（ＮＩＤＤＭ）患者尿液;α１－微球蛋白（α－ＭＧ）,β２－微球蛋白（β２－ＭＧ）Ｔａｍｍ－Ｈｏｒｓｆａｌｌ蛋白（ＴＨＰ）,白蛋白（ＡＬｂ）及免疫球蛋白Ｇ（ＩｇＧ）含量。结果：随着ＣＣｒ值的下降,尿α１－ＭＧ,β２－ＭＧ,ＡＬｂ及ＩｇＧ排泄量逐渐增高,而     

对苯二甲酸接触工人尿酶及微球蛋白的变化

选择１２７名ＴＰＡ作业工人进行动式个体采样,并留取１２７名ＴＰＡ作业工人当日工前工后尿样和７０名对照工人的工前尿。对尿样中γ谷氨酰转肽酶（ＧＧＴ）、碱性磷酸酶（ＡＬＰ）、乳酸脱氢酶（ＬＤＨ）、Ｎ乙酰βＤ氨基葡糖苷酶（ＮＡＧ）活性以及尿ＴＰＡ、α１微球蛋白（α１ＭＧ）、β２微球蛋白（β２ＭＧ）水平进行分析。结果显示,ＴＰＡ接触组尿ＧＧＴ、ＡＬＰ、ＬＤＨ、ＮＡＧ活性以及尿α１ＭＧ、β２ＭＧ水平与对照组相比无显著差别,而５～ｍｍｏｌ／ｍｏｌ．Ｃｒ尿ＴＰＡ负荷组工人尿β２ＭＧ与对照组相比有明显升高（Ｐ＜００５）,尿β２ＭＧ与尿ＴＰＡ负荷量呈现一定的剂量依赖关系。尿ＴＰＡ水平对尿酶活性、α１ＭＧ均未产生明显影响。不同累积接尘量和不同工龄的工人尿酶和微球蛋白无明显差异。提示ＴＰＡ对肾实质可造成一过性可逆性影响,尚不能说明肾实质受到器质性损伤。     

Elevated urinary β2 microglobulin in the first identified Japanese family afflicted by X-linked myopathy with excessive autophagy

Here we report what is to our knowledge the first identified Japanese family afflicted by X-linked myopathy with excessive autophagy. The index case is a 52-year-old man with almost 40 years of progressive proximal muscle weakness. High urinary β2 microglobulin, normal serum β2 microglobulin, autophagic vacuoles with sarcolemmal features, and a hemizygous c.164–7T>G mutation in the VMA21 gene were found. His two maternal uncles had similar clinicopathological findings. High urinary β2 microglobulin without obvious renal dysfunction might result from decreased urine acidification in the distal convoluted tubules caused by the VMA21 gene mutation. These findings might prove to be useful as a preliminary marker suggestive of X-linked myopathy with excessive autophagy.     

同型半胱氨酸和β2撇蛋白检测在糖尿病肾病早期诊断中的意义

目的：探讨同型半胱氨酸和β2-微球蛋白检测技术在临床上早期诊断糖尿病肾病中的意义和价值。方法：选择2012年2月-2013年8月本院确诊的63例糖尿病肾病患者为观察组,选择同时期57例在本院进行健康体检者为对照组,采集血液样本后利用循环酶法和乳胶增强免疫比浊法,在全自动生化分析仪上分别对两组血液样本中同型半胱氨酸和β2-微球蛋白水平进行检测并比较,同时也对血清学指标尿素和肌酐含量进行了测定和比较。结果：观察组同型半胱氨酸、β2-微球蛋白、尿素和肌酐含量均明显高于对照组（t=29.5302、17.4914、44.8168、9.0717,P〈0.01）;处于糖尿病肾病Ⅰ期、Ⅱ期、Ⅲ期和Ⅳ期患者的同型半胱氨酸和β2-微球蛋白含量呈递增性增加;处于糖尿病肾病Ⅱ期、Ⅲ期和Ⅳ期患者的同型半胱氨酸和β2-微球蛋白含量明显高于糖病肾病Ⅰ期患者,差异均有统计学意义（t=8.5199、9.8964、15.3487,P〈0.01;t=3.0382、7.6056、7.0711,P〈0.01）。结论：联合检测患者同型半胱氨酸和β2-微球蛋白水平有助于糖尿病肾病的早期诊断,检测结果能够为临床上糖尿病肾病患者治疗提供参考依据,值得在临床上推广和应用。     

Determinants of Plasma {beta}2 Microglobulin Concentration: Possible Relation to Membrane Biocompatibility

Beta₂ microglobulin (ß₂m) concentrations were measuredby radioimmunoassay in the serum of haemodialysed patients.ß₂m was higher in males (n=48) than in females (n=26),i.e. 40.3±10.1 mg/l (SD) vs 31.2±8.0, P<0.01).ß₂m was not significantly higher in patients withbone cysts (37.7±11.4 mg/l vs 37.0±10.0), butmedian duration of dialysis was significantly (P<0.01) longerin patients with bone cysts (90 vs 57 months). ß₂mwas lower in patients maintained on dialysis for less than 1year and whose residual urine volume was greater than 0.1 litreper day. During one single session of dialysis, using cuprophanemembranes, ß₂m increased acutely at 15 min and hadrisen by 32.4% at the end of the dialysis session, more thancould be explained by haemoconcentration. In contrast, ß₂macutely decreased by 38.7% during a single session using polysulphonemembranes and the steady state predialysis values were lowerby 37.1% after two weeks intermittent haemodialysis with polysulphonemembranes. After re-exposure to cuprophane serum ß₂mincreased to the original value. It is concluded that ß₂m concentrations on dialysisare a function of residual urinary volume, sex, and type ofmembrane used. Data are consistent with effective removal ofß₂m by membranes with high cut-off.     

血清β2—微球蛋白测定在消化系统疾病中的应用价值

目的：探讨血清β2－微球蛋白（β2-Microglobulin,β2-MG）在消化系统疾病中的变化水平和诊断价值。方法：采用放射免疫分析法检测112例消化系统恶性肿瘤和173例消化系统良性疾病患和60例正常人的血清β2-MG水平，结果：消化系统恶性肿瘤比消化系统良性疾病和正常人的血清β2-MG明显增高（P＜0．05），高β2-MG血症发生率消化系统恶性肿瘤（63．39％）较良性疾病（16．76％）明显增高（P＜0．01），血清β2-MG增高在进展期肿瘤中占92．86％，相对稳定期肿瘤中仅占53．57％（P＜0．01），结论：血清β2-MG有助于鉴别消化系统良、恶性疾病，而动态观察肿瘤患的血清β2-MG变化对判断病程进展，评价预后有一定的临床实用价值。     

Value of β2-microglobulin in the serum of healthy subjects older than 40 years

The aim of this research was to determine if the age of healthy subjects older than 40 years of age has an influence on the concentration of β(2) -microglobulin in the serum of subjects of different populations. We examined the values of β(2) -microglobulin in the serum of 51 healthy subjects aged 40-86 years using the microparticle enzyme immunoassay AxSYM β(2) -microglobulin test. The reference values of β(2) -microglobulin according to the nonparametric statistical method is 0.95-2.73 mg/L. A correlation was found between β(2) -microglobulin and age: 40-50 years (0.94-1.54 mg/L), 51-65 years (0.96-2.62 mg/L), and >65 years (1.13-2.84 mg/L). There was no significant statistical difference of β(2) -microglobulin between genders (P > 0.05); however, there was a statistically significant difference between the concentration of β(2) -microglobulin and the subjects' age. (Spearman's rank correlation coefficient ρ = 0.66; P < 0.01). A direct correlation between age and the concentration of β(2) -microglobulin was observed. This research is a contribution to determining reference values of β(2) -microglobulin in subjects of different populations.     

循环microRNA、微球蛋白与急性心肌梗死的相关性分析

目的:探讨分析循环microRNA、微球蛋白与急性心肌梗死的相关性.方法:选取2012年7月～2013年2月于本院进行诊治的54例急性心肌梗死患者为观察组,同时期体检的54例健康人员为对照组,比较两组人员及观察组不同Killip分级患者的循环microRNA、微球蛋白水平,并分析上述指标与急性心肌梗死的相关性.结果:观察组的α1-微球蛋白(α1-MG)、β2-微球蛋白(β2-MG)、microRNA-499、microRNA-214及microRNA-208均高于对照组,microRNA-21低于对照组,且观察组Killip分级高者波动大于分级低者,差异均有统计学意义(P均＜0.05);上述指标均与急性心肌梗死有密切的相关性.结论:急性心肌梗死患者的循环microRNA与微球蛋白呈现异常状态,且不同Killip分级者存在明显的差异,其与急性心肌梗死有明显的相关性.     

人精浆中铁蛋白与β_2-微球蛋白测定及临床意义

目的 :探讨精浆中铁蛋白 (Fer)和 β2 微球蛋白 (β2 MG)含量与不育症的关系。　方法 :用放射免疫分析方法对 2 2例正常生育者和 12 5例不育者精浆中Fer和 β2 MG进行了检测。　结果 :不育男性精浆中Fer含量明显高于正常生育组 ,β2 MG含量明显低于生育组 ,不育与生育者之间存在高度显著性差异 (P <0 0 1) ,并且精浆中Fer与 β2 MG含量与精子密度之间存在密切的相关关系。　结论 :测定精浆中Fer与 β2 MG含量可以帮助判断男性不育者的状态 ,指导临床对其进行有效的治疗     

Renal tubular dysfunction in primary Sjögren's syndrome: Clinical studies in 27 patients

Summary Kidney involvement in Sjögren's syndrome (SS) including renal tubular disorders are well recognized but little is known about frequency and extent of such dysfunction in the general population of patients with primary SS, due to a lack of group studies. We studied 27 patients with primary SS and without other possible causes of tubular dysfunction. Increased urinary 2M excretion, due to proximal tubular dysfunction, was present in 26% of patients. Inadequate urine acidification after oral NH₄ Cl, proving distal tubular dysfunction, was found in 12% of the patients studied. Concentrating ability, tested by thirst, was decreased in 44% of patients studied. Abnormal renal tubular tests correlated with presence of ANA (p=0.05) but not with other clinical parameters. In conclusion demonstrable renal tubular dysfunctions occur in over half the patients with primary SS. Literature concerning this subject is discussed.