尿液视黄醇结合蛋白检测在肾功能早期损伤中的诊断价值

目的探讨尿液视黄醇结合蛋白（RBP）在肾功能早期损伤中的诊断价值。方法检测445例肾功能损伤患者尿液RBP、微量白蛋白（mAlb）、免疫球蛋白（Ig）、转铁蛋白（Tr）、α1-微球蛋白（α1-MG）、N-乙酰-β-D氨基葡萄糖苷酶（NAG）,同时测定其肌酐（Cr）值。根据mAlb/Cr值分为3组：正常蛋白尿组（mAlb/Cr〈25.0mg/g）、微量蛋白尿组（mAlb/Cr为25～250mg/g）和大量蛋白尿组（mAlb/Cr〉250mg/g）,分析各组患者尿RBP与上述蛋白含量水平的差异及其相关性。结果随着尿mAlb排泄率的增加,尿液中各蛋白含量明显增高,大量蛋白尿组〉微量蛋白尿组〉正常蛋白尿组和对照组（P均〈0.01）。正常蛋白尿组mAlb、α1-MG、及RBP均明显高于对照组（P〈0.01）,尿Ig、Tr和NAG无差异（P〉0.05）;微量蛋白尿组中除NAG与正常蛋白尿组无差异外（P〉0.05）,其他蛋白均高于正常蛋白尿组（P〈0.01）。相关性分析发现,RBP与mAlb、Ig、Tr、α1-MG、NAG等均呈相关相关系数（r）分别为0.904、0.707、0.701、0.392、0.301,P均〈0.01]。但在各组样本中相关性有一定差异：正常蛋白尿组和微量蛋白尿组RBP均与mAlb、Ig、NAG呈正相关（正常蛋白尿组r分别为0.746、0.178,0.224,P均〈0.01;微量蛋白尿组r分别为0.748、0.225、0.268,P均〈0.01）。大量蛋白尿组中RBP与α1-MG呈正相关（r=0.374,P〈0.01）。结论尿RBP是评价肾功能早期损伤的良好指标之一。

The diagnosis significance of determining urine retinol-binding protein on early renal function injury

Objective To study the diagnosis significance of urine retinol-binding protein（ RBP） on early renal function injury. Methods The concentrations of RBP,microalbumin （ mAlb） ,immunoglobin （ Ig） ,transferrin （ Tr） ,α1-microglobulin（ α1-MG） and N-acetyl-β-D glucosaminidase（ NAG） in urine were determined in 445 patients with renal function injury. The concentration of creatinine （ Cr） was determined simultaneously. According to the value of mAlb/Cr,the patients were classified into 3 groups：the normal albuminuria group （ mAlb/Cr 25. 0 mg/g） ,the microalbuminuria group （ mAlb/Cr between 25-250 mg/g） and the macroalbuminuria group （ mAlb/Cr 250 mg/g）. The difference and correlation between RBP and other proteins were analyzed. Results With the increasing of mAlb excretory rate,the levels of the urine proteins were increasing. The levels in macroalbuminuria group were higher than those in microalbuminuria group,and the levels in normal albuminuria group and control group were lower than those in microalbuminuria group. The differences were significant in all groups （ P〈0. 01）. The levels of mAlb,α1-MG and RBP in normal albuminuria group were higher than those in control group （ P〈0. 01） ,however,there was no difference in the levels of Ig,Tr and NAG between the two groups （ P〈0. 05）. In microalbuminuria group,all the proteins were higher than those of normal albuminuria group （ P〈0. 01） except NAG （ P〈0. 05）. RBP was positively correlated with mAlb,Ig,Tr,α1-MG and NAG（ r = 0. 904,0. 707,0. 701,0. 392 and 0. 301,P〈0. 01） ,but there was a bit of difference between each group. In normal albuminuria group,RBP was positively correlated with mAlb,Ig and NAG（ r = 0. 746,0. 178 and 0. 224,P〈0. 01）. In microalbuminuria group,RBP was positively correlated with mAlb,Ig and NAG（ r = 0. 748,0. 225 and 0. 268,P〈0. 01）. In macroalbuminuria group,RBP was positively correlated with α1-MG （ r =0. 374,P〈0. 01）. Conclusions Urine RBP is one of the good indexes in evaluating early renal function injury.