| 摘要: |
| ［摘要］目的 观察原发性肾病综合征（primary nephrotic syndrome，PNS）患者尿β2-微球蛋白（β2-microglobulin， β2-MG）、尿视黄醇结合蛋白（retinol conjugated protein，RBP）、尿N-乙酰-β-D-氨基酸核苷酶（N-acetyl-beta-D nucleosidase amino acids， NAG）以及血清胱抑素C（cystatin C， Cyst C）水平变化，探讨其在原发性肾病综合征诊断中的应用价值．方法 选取2009年9月至2015年9月就诊的53例原发性肾病综合征患者为研究对象，另选取同期健康体检者40例为对照组，检测2组人员尿β2-MG、RBP、NAG以及血Cys C水平并进行统计学分析，绘制受试者工作曲线（receiver operator characteristic curve， ROC），评价4种肾小管标志物对原发性肾病综合征的诊断效果．结果 原发性肾病综合征患者尿β2-MG、RBP、NAG以及血Cys C水平较健康对照组均显著升高，差异具有统计学意义（P＜0.01）．尿RBP、NAG以及血Cys C对原发性肾病综合征的检测效能均显著优于尿β2-MG （P＜0.05），而尿RBP、NAG以及血Cys C的检测效能无统计学意义（P＞0.05）．通过ROC曲线分析可知：尿RBP的曲线下面积为0.897（95%CI为0.807～0.987）大于尿NAG、血Cys C及尿β2-MG曲线下面积．结论 4种肾小管标志物对原发性肾病综合征的诊断具有较高的敏感度和特异度，检测尿β2-MG、RBP、NAG以及血Cys C水平，有助于原发性肾病综合征患者的诊断以及指导临床治疗． |
| 关键词: ［关键词］原发性肾病综合征 β2-微球蛋白 视黄醇结合蛋白 N-乙酰-β-D-氨基葡萄糖苷酶 半胱氨酸蛋白酶抑制剂C |
| DOI： |
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| 基金项目:［基金项目］河北省中医药管理局课题基金资助项目（2013HB356） |
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| The Value of Renal Tubular Injury Biomarkers in Diagnosis of Primary Nephrotic Syndrome |
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LIU Yu1,2
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1.（1）Dept. of Internal Medicine，Mianyang Traditional Chinese Medicine Hospital of Sichuan Province，Mianyang Sichuan 621000;2）Dept. of Nephrology，The First Hospital of Hebei Medical University，Shijiazhuang Hebei 050000，China）
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| Abstract: |
| ［Abstract］Objective To investigate the changes of urinary β2-microglobulin （β2-MG）， retinol conjugated protein （RBP）， N-acetyl-beta-D nucleosidase amino acids （NAG） and serum cystatin C （Cys C） in patients with primary nephrotic syndrome （PNS）， and explore the application value of those indexes in PNS diagnosis. Methods Fifty-three patients with PNS from Sep. 2009 to Sep. 2015 were enrolled in this study， and 40 healthy people were selected as the control group. The levels of β2-MG， RBP， NAG in urinary and Cys C in serum were measured in two groups， and the receiver operator characteristic curves （ROC） were drawn out for investigating the diagnostic value of four indexes to PNS. Results The levels of β2-MG， RBP， NAG in urinary and Cys C in serum of patients with PNS were significantly higher than control group （P＜0.01）. The RBP， NAG and Cys C had the higher efficiency in diagnosis PNS than β2-MG， the differences were statistically significant （P＜0.05）. There were no significant differences in diagnosis PNS between RBP， NAG and Cys C （P＞0.05）. The area of RBP under the ROC curve was 0.897（95%CI was 0.807-0.987）bigger than NAG， Cys C and β2-MG. Conclusion β2-MG， RBP， NAG in urinary and Cys C in serum have high sensitivity and specificity in diagnosis PNS， monitoring the levels of β2-MG，RBP，NAG in urinary and Cys C in serum may be helpful for diagnosis and clinical therapy of PNS. |
| Key words: ［Key words］Primary nephrotic syndrome β2-microglobulin Retinol conjugated protein N-acetyl－beta－D nucleosidase amino acids Cystatin C |