脑外伤患者尿微量蛋白测定的应用价值

目的:探讨尿微量蛋白诊断脑外伤患者早期肾功能损害的临床价值。方法:检测962例脑外伤患者尿α1-微球蛋白(α1-M)、微量白蛋白(MA)、转铁蛋白(Tf)、免疫球蛋白G(IgG)、γ-谷氨酰转肽酶(GGT)含量,同时检测血尿素氮(BUN)、肌酐(Cr)含量。结果:74.0%脑外伤患者尿中不同程度地出现一种或多种微量蛋白,且随伤情程度的加重,尿微量蛋白的种类及数量排泄增多。GCS分值与α1-M(r=-0.66)、MA(r=-0.54)、Tf(r=-0.42)、IgG(r=-0.50)、GGT(r=-0.39)、BUN(r=-0.25)、Cr(r=-0.19)呈负相关。结论:脑外伤患者确实存在不同程度的早期肾功能损害,尿微量蛋白是诊断早期肾功能损害灵敏、可靠的指标,而尿γ-谷氨酰转肽酶,血尿素氮、肌酐的诊断价值则不理想。

Clinical value of uromicroprotein in patients with brain injury

Objective: To investigate the clinical value of uromicroprotein in the diagnosis of the brain-injuried patients with early kidney lesion. Methods:The concentrations of urinary α1-microglobulin(α1-M),microalbumin(MA), transferrine(Tf),immunoglobulin G(IgG) and Gamma-glutamyl transferase(GGT) were measured in 962 patients with brain injury.Simultaneously blood urea nitrogen(BUN) and serum creatinine(Cr) were determined in all patients. Results: 74.0% of patients had one kind or various uromicroproteins in different degree. The amount of uromicroprote insincreased with the severity of the injury.GCS score was negatively correlated with α1-M(r=-0.66),MA(r=-0.54),Tf(r=-0.42),IgG(r=-0.50),GGT(r=-0.39),BUN(r=-0.25), Cr(r=-0.19).Conclusion: The brain-injuried patients have early kidney lesion.Uromicroprotein is a sensitive and reliable clinical index for the diagnosis of early kidney lesion in brain-injuried patients,but GGT,BUN and Cr are not ideal for the clinical application