Diagnostic value of combined detection of four-item urinary protein for early hypertensive kidney injury

中国基层医药 Pub Date : 2020-04-01 DOI:10.3760/CMA.J.ISSN.1008-6706.2020.07.004

Yajun Ma, Peng Cheng, Fudi Chu

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Abstract

Objective To investigate the diagnostic value of combined detection of urine α1-microglobulin(α1-mG), N-acetyl-β-D-glucosaminidase (NAG), retinol binding protein (RBP) and β2-microglobulin (β2-mG) for early hypertensive kidney injury. Methods From June 2016 to December 2018, 116 hypertension patients with renal damage (HRD group) and 44 cases with simple hypertension(HBP group) were selected in the Central People′s Hospital of Tengzhou in this study.And 36 cases of healthy people during the same period were selected as the control group.One hundred and sixteen cases of the HRD group were divided into Ⅰ-Ⅱ group (61 cases) and Ⅲ-Ⅴ group (55 cases) according to the classification of chronic kidney disease(CKD). The concentrations of α1-mG, NAG, RBP and β2-mG in urine were detected in patients and healthy people respectively.SPSS 19.0 software was used to perform statistical analysis. Results The concentrations of urine α1-mG, NAG, RBP, β2-mG in the HRD group were (41.77±24.21)mg/L, (22.60±13.24)U/L, (2.86±1.73)mg/L, (1.76±0.95)mg/L, respectively, which in the HBP group were (12.49±8.10)mg/L, (13.45±8.61)U/L, (0.31±0.16)mg/L, (0.38±0.38)mg/L, respectively, which in the control group were (4.37±2.52)mg/L, (6.12±3.57)U/L, (0.29±0.17)mg/L, (0.28±0.15)mg/L, respectively.The concentrations of urine α1-mG, NAG, RBP, β2-mG in the HRD group were significantly higher than those in the HBP group(t=4.07, 4.25, 4.09, 4.03, all P<0.05) and the control group(t=3.15, 4.94, 2.49, 2.61, all P<0.05). The urine levels of α1-mG, NAG, RBP, β2-mG in phase Ⅰ-Ⅱ group were (21.62±13.45)mg/L, (21.96±12.49)U/L, (0.5±0.47)mg/L, (0.93±0.62)mg/L, respectively, which in the phase Ⅲ-Ⅴ group were (64.11±60.12)mg/L, (23.32±14.11)U/L, (5.48±4.77)mg/L, (2.68±2.55)mg/L, respectively.The concentrations of urine α1-mG, NAG, RBP and β2-mG in Ⅰ-Ⅱ group (t=5.08, 4.99, 2.96, 1.66, all P<0.05) and Ⅲ-Ⅴ group (t=3.95, 4.81, 4.33, 3.74, all P<0.05) were significantly higher than those in the control group.The levels of α1-mG, RBP and β2-mG in group Ⅲ-Ⅴ were higher than those in group Ⅰ-Ⅱ(t=5.37, 8.11, 4.52, all P<0.05). The positive detection rates of α1-mG, NAG, RBP, β2-mG and combination test in phase Ⅰ-Ⅱ group were 70.5%, 77.0%, 19.7%, 60.7%, 91.8%, respectively, which in the phase Ⅲ-Ⅴ group were 81.8%, 81.8%, 69.1%, 69.1% and 96.4%, respectively.The positive rate of urine α1-mG, NAG, RBP and β2-mG combination test was significantly higher than that of the single detection (phase Ⅰ-Ⅱ group: χ2=7.71, 3.99, 61.4, 14.65; phase Ⅲ-Ⅴ group: χ2=4.58, 4.58, 12.47, 12.47; all P<0.05). Conclusion Urine α1-mG, NAG, RBP and β2-mG are important biochemical indicators in patients with early hypertensive kidney injury.The combined detection of the four tests has high diagnostic value in the diagnosis of early hypertensive nephropathy. Key words: Hypertension; Urine protein; Early hypertensive kidney injury; α1-microglobulin; N-acetyl-β-D-glucosaminidase; Retinol binding protein; β2-microglobulin; Combined detection

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四项尿蛋白联合检测对早期高血压肾损伤的诊断价值

目的探讨尿α1-微球蛋白(α1-mG)、n -乙酰-β- d -氨基葡萄糖苷酶(NAG)、视黄醇结合蛋白(RBP)和β2-微球蛋白(β2-mG)联合检测对早期高血压肾损伤的诊断价值。方法选择2016年6月~ 2018年12月滕州市中心人民医院肾损害高血压患者116例(HRD组)和单纯性高血压患者44例(HBP组)。选取同期健康人群36例作为对照组。116例HRD组按慢性肾病(CKD)的分型分为Ⅰ-Ⅱ组(61例)和Ⅲ-Ⅴ组(55例)。分别检测患者和正常人尿液中α1-mG、NAG、RBP和β2-mG的浓度。采用SPSS 19.0软件进行统计分析。结果HRD组尿α1-mG、NAG、RBP、β2-mG浓度分别为(41.77±24.21)mg/L、(22.60±13.24)U/L、(2.86±1.73)mg/L、(1.76±0.95)mg/L, HBP组分别为(12.49±8.10)mg/L、(13.45±8.61)U/L、(0.31±0.16)mg/L、(0.38±0.38)mg/L，对照组分别为(4.37±2.52)mg/L、(6.12±3.57)U/L、(0.29±0.17)mg/L、(0.28±0.15)mg/L。HRD组尿α1-mG、NAG、RBP、β2-mG浓度均显著高于HBP组(t=4.07、4.25、4.09、4.03，均P<0.05)和对照组(t=3.15、4.94、2.49、2.61，均P<0.05)。Ⅰ-Ⅱ期组α1-mG、NAG、RBP、β2-mG水平分别为(21.62±13.45)mg/L、(21.96±12.49)U/L、(0.5±0.47)mg/L、(0.93±0.62)mg/L，Ⅲ-Ⅴ期组α1-mG /L、NAG、RBP、β2-mG水平分别为(64.11±60.12)mg/L、(23.32±14.11)U/L、(5.48±4.77)mg/L、(2.68±2.55)mg/L。Ⅰ-Ⅱ组(t=5.08、4.99、2.96、1.66，均P<0.05)和Ⅲ-Ⅴ组(t=3.95、4.81、4.33、3.74，均P<0.05)尿α1-mG、NAG、RBP、β2-mG浓度均显著高于对照组。Ⅲ-Ⅴ组α1-mG、RBP、β2-mG水平均高于Ⅰ-Ⅱ组(t=5.37、8.11、4.52,P均<0.05)。Ⅰ-Ⅱ期组α1-mG、NAG、RBP、β2-mG及联合检测阳性检出率分别为70.5%、77.0%、19.7%、60.7%、91.8%，Ⅲ-Ⅴ期组α1-mG、NAG、RBP、β2-mG及联合检测阳性检出率分别为81.8%、81.8%、69.1%、69.1%和96.4%。尿α1-mG、NAG、RBP、β2-mG联合检测阳性率显著高于单项检测(Ⅰ-Ⅱ期)组:χ2=7.71、3.99、61.4、14.65;Ⅲ-Ⅴ阶段组:χ2=4.58, 4.58, 12.47, 12.47;所有P < 0.05)。结论尿α1-mG、NAG、RBP、β2-mG是早期高血压肾损伤患者重要的生化指标。四项检查联合检测对早期高血压肾病的诊断有较高的诊断价值。关键词:高血压;尿蛋白;早期高血压肾损伤;α1-microglobulin;n -乙酰-β-D-glucosaminidase;视黄醇结合蛋白;β2-microglobulin;联合检测

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来源期刊

中国基层医药

CiteScore

0.10

自引率

0.00%

发文量

32251

期刊介绍： Since its inception, the journal "Chinese Primary Medicine" has adhered to the development strategy of "based in China, serving the grassroots, and facing the world" as its publishing concept, reporting a large amount of the latest medical information at home and abroad, prospering the academic field of primary medicine, and is praised by readers as a medical encyclopedia that updates knowledge. It is a core journal in China's medical and health field, and its influence index (CI) ranks Q2 in China's academic journals in 2022. It was included in the American Chemical Abstracts in 2008, the World Health Organization Western Pacific Regional Medical Index (WPRIM) in 2009, and the Japan Science and Technology Agency Database (JST) and Scopus Database in 2018, and was included in the Wanfang Data-China Digital Journal Group and the China Academic Journal Comprehensive Evaluation Database.