不同电泳方法对尿蛋白分析的临床意义。

L Balant, J Fabre
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引用次数: 0

摘要

在临床实验室中,通常有三种电泳技术可用于尿蛋白模式的定性研究:1)醋酸纤维素,2)免疫电泳;3) sds -聚丙烯酰胺凝胶电泳。蛋白尿(蛋白质排泄量超过150毫克/天或100微克/分钟)通常表明肾小球毛细血管膜通透性增加或小管重吸收减少。由于肾小球疾病与白蛋白和高分子量蛋白质的清除率增加有关,而小管损伤与比白蛋白低分子量蛋白质的主要排泄有关,因此根据其成分的分子量建立蛋白尿分类似乎是合乎逻辑的。因此可以基本区分5种类型的蛋白尿:1)生理性;2)管状;3)选择性肾小球;4)非选择性肾小球;5)混合性蛋白尿。此外,必须区分“骨髓瘤蛋白尿”,即在尿液中发现单克隆完全或不完全γ -球蛋白。在临床上,确定定量正常的蛋白尿的定性正常或病理特征可能是有用的,特别是在以下情况下:1)对肾病患者的早期诊断,如糖尿病患者,这些患者特别容易发生肾脏并发症;2)确认临床治愈或预测肾脏疾病复发;3)直立性或骨髓瘤蛋白尿,或任何不明原因的尿蛋白输出升高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical relevance of different electrophoretic methods for the analysis of urinary proteins.

Three electrophoretic techniques are usually available in the clinical laboratories for the qualitative investigation of urinary protein patterns: 1) acetate cellulose, 2) immuno-electrophoresis; and 3) SDS-polyacrylamide gel electrophoresis. Proteinuria (the excretion of proteins in excess of 150 mg/day or 100 microgram/min) usually signifies either increased permeability of the glomerular-capillary membrane of diminished tubular reabsorption. Since glomerular disease is associated with an increased clearance of albumin and higher molecular weight proteins, whereas tubular damage is associated with the predominant excretion of proteins of lower molecular weight than albumin, it seems logical to establish a classification of proteinuria according to the molecular weight of its constituents. One can thus basically distinguish 5 types of proteinurias: 1) physiological; 2) tubular; 3) selective glomerular; 4) non selective glomerular; and 5) mixed proteinurias. Additionally one must distinguish "myeloma proteinurias" where monoclonal complete or incomplete gamma-globulins are found in the urine. Clinically it may be useful to determine the qualitatively normal or pathologic character of a quantitatively normal proteinuria, especially in the following conditions: 1) for early diagnosis of nephropathy in patients, such as diabetics, which are particularly prone to suffer from renal complications; 2) to confirm the clinical cure or to predict the recurrence of renal diseases; and 3) in such situations as orthostatic, or myeloma proteinuria, or any elevation of the urinary protein output of unknown etiology.

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