尿沉渣及尿RBP、NAG检测与急性肾衰肾活检相关性

目的探讨尿沉渣检查及尿RBP、NAG检测能否反应急性肾衰患者的肾脏病理损伤。方法100例急性肾衰患者在肾脏病理活检前一日或当日取晨尿进行尿沉渣相差显微镜镜检及ELISA法和生化法分别测定RBP、NAG，比较不同病理改变的尿沉渣及尿RBP、NAG分泌特点。结果肾小球增殖性病变（PGD）为主的65例患者中60例为Ⅰ类尿沉渣谱（92．3％），RBP、NAG正常或略有增高；非肾小球增殖病变（NPGD）为主的10例患者中9例为Ⅱ类尿沉渣谱（90．0％），3例（30．0％）伴急性肾小管坏死的患者尿RBP、NAG异常；小管间质病变（TID）为主的25例中23例为Ⅲ类尿沉渣谱（92．0％），尿RBC、NAG明显增高。结论尿沉渣镜检、尿RBP、NAG测定在一定程度上能反应肾脏病理损伤的部位及程度，具有一定的临床意义。

Significance of detection of urinary sediment,RBP,NAG and renal pathological biopsy in analysis of acute renal failure

Objective To investigate the clinical significance of detection of urinary sediment, urinary RBP and NAG in renal pathological changes in acute renal failure. Methods Fresh morning urine specimens were collected from 100 patients with acute renal failure （ARF） and the contents of RBP and NAG were determined with phase contrast micrescoe. ELISA and biochemistry. The results were pathologically analyzed. Results Out of the 65 PGD patients 60 cases were cytodiagnostic urinalysis type Ⅰ （92.3%）, and their contetns of RBP and NAG were normal or elevated lightly; out of 10 NPGD patients 9 cases were cytodiagnostic urinalysis type Ⅱ （90.0%）, and contents of urinary RBP and NAG in 3 patients with acute tubular necrosis were abnormal. Of the 25 TID patients 23 cases were cytodiagnostic urinalysis type Ⅲ （90.0%）, and their contents of RBP and NAG were elevated markedly. Conclusion The examinaion of urinary sediments, urinary RBP and NAG could, to a certain extent disclosevthe position and grades of renal pathological lesionsv.