胡桃夹综合征患者不同体位尿蛋白定量检测的日内变异分析

目的报道2例胡桃夹综合征患者随机尿微量清蛋白肌酐比(ACR)、总蛋白肌酐比(PCR)与24 h尿总蛋白定量(24hUTP)结果不一致的临床案例,并分析患者不同体位时随机尿蛋白的日内变异。方法用多普勒超声确诊2位患者为胡桃夹综合征,留取2位患者不同体位(平卧、正常活动)24 h期间所有尿标本,检测ACR、PCR、24hUTP,分析不同体位下ACR、PCR的变异及与24hUTP的一致性。结果平卧期间,2位患者随机尿ACR、PCR和24hUTP均在参考区间内,结果均一致;正常活动期间,2位患者随机尿ACR和PCR都有个别异常升高超出参考区间,24hUTP分别是0.21 g/24 h和0.05 g/24 h,结果严重不一致。结论胡桃夹综合征会引起体位性蛋白尿,从而导致患者随机尿蛋白日内变异较大,出现个别随机尿蛋白与24hUTP结果不一致的情况,建议患者用晨起第1次尿和24 h尿来监测尿蛋白的排泄情况。

Intra-day variation analysis of quantitative detection of urine protein in different positions of patients with nutcracker syndrome

Objective To analyze 2 cases of nutcracker syndrome with inconsistent results of random urine microalbumin creatinine ratio (ACR) and total urinary protein creatinine ratio (PCR) and 24-hour urinary total protein quantification (24-hour UTP). Methods The protein results of urine and 24-hour urine of two patients during 24 hours of recumbent and normal activity were analyzed. Results During the recumbent period, ACR, PCR in and 24 hUTP were all within the reference range. During the normal activity period, ACR, PCR in random urine exceeded the reference range several times, while 24 hUTP was 0.21 and 0.05 g/24h, respectively. Conclusion Nutcracker syndrome can cause postural proteinuria, which results in a large variation of proteinuria within days. Some random urine are inconsistent with 24-hour urine proteinuria results.