β2-MG、GFR在肺癌化疗中对肾功能的评价

目的探讨血、尿β2-微球蛋白（β2-microglobin,MG）及肾小球滤过率（glomerular filtration rate,GFR）在肺癌化疗中对肾功能评价的临床意义。方法将64例肺癌患者随机分为2组,小剂量顺铂组32例（DDP60mg/m2）,大剂量顺铂组32例（DDP100mg/m2）,分别在化疗前、化疗后4d和3周时测定血、尿β2-MG、GFR及同期测得的血清尿素氮（blood urea nitrogen,BUN）、肌酐（creatinine,Cr）进行分析比较。结果小剂量顺铂组尿β2-MG化疗后4d较化疗前明显升高（P〈0.01）;而大剂量顺铂组血、尿β2-MG及GFR化疗后4d较化疗前均明显升高（P〈0.01）,3周后复查,除GFR明显升高（P〈0.01）外,其余均恢复正常。BUN、Cr在化疗前、化疗后4d和3周时差异均无统计学意义（P〉0.05）。结论血、尿β2-MG及GFR具有较好的早期肾损伤诊断价值,且较血BUN、Cr更灵敏。

Evaluation of Renal Function by B2-Microglobulin and Glomerular Filtration Rate in Lung Cancer Chemotherapy

Objective To study the clinical application of blood and urine β2-microglobulin（β2-MG） and glomerular filtration rate（GFR） as the standard of renal function evaluation in lung cancer chemotherapy treatment. Methods 64 cases with lung cancer were divided into group A （small DDP dosage group ,32 cases, DDP 60 mg/m2） and B （large DDP dosage group, 32 cases, DDP 100 mg/m2）. The blood β2-MG,urine β2-MG, GFR and blood urea nitrogen（BUN）, creatinine（Cr） were analyzed before chemotherapy and 4 days ,3 weeks after chemotherapy from the onset of treatment. Results The urine β2-MG increased obviously 4 days after chemotherapy in group A（P 〈0. 01 ） ;while the blood and urine β2-MG and GFR all increased 4 days after_chemotherapy in group B （P 〈 0.01 ）, but only GFR remained high level 3 weeks after chemotherapy（ P 〈0.01 ）. There was no statistical difference in blood BUN and Cr before and after the chemotherapy （ P 〉 0.05 ）. Conclusions The blood and urine β2-MG and GFR are more sensitive than blood BUN and Cr in the early diagnosis of renal function damage.