尿蛋白谱及尿轻链水平的检测在慢性肾脏损伤中的诊断意义

Clinical application of detecting urine protein spectrum and light chain levels in chronic kidney injury

关键词:  尿蛋白谱  尿轻链  慢性肾脏损伤

Key words:  urine protein spectrum  urine light chain  chronic kidney damage

摘要:

［目的］检测慢性肾脏损伤患者尿蛋白谱及尿中轻链水平评价肾脏损伤的部位和程度。［方法］根据慢性肾脏病诊断标准，结合病史及靶器官受损情况，选取原发或继发原因能够引起慢性肾脏损伤的患者195例分为1~6组，无肾脏损伤组（1组）、有肾脏损伤患者根据尿蛋白阳性程度分为2组（±）、3组（+）、4组（++）、5组（+++）、6组（++++）。另设健康对照组（0组）30例。采用散射免疫比浊原理检测尿蛋白谱、尿轻链。［结果］除了1组IgG、mAlb、TRF与健康对照组比较差异无显著性意义（P>0.05）外,其他2~6组尿蛋白指标与健康对照组比较差异均有显著性意义（P<0.05）。相关分析结果显示，各指标检测结果与尿蛋白程度分级均呈高度相关（P<0.05）。且随着尿蛋白程度加重（±～＋＋＋＋），同组不同患者同一指标变异程度也增加。［结论］尿中不同蛋白水平升高程度反映了肾脏不同部位的损伤程度，且随着尿蛋白程度加重，同组不同患者同一指标的变异程度增加，应根据具体情况制定相应治疗措施。

Abstract:

［Objective］Detecting urinary protein spectrum and urinary light chain in patients with chronic kidney injury to evaluate the region and extent of damage in the kidney. ［Methods］By reference to the internal (7th Edition), according to diagnostic criteria of chronic kidney disease, combining with medical history and the damage of target organs, we selected 195 patients with primary or secondary causes of chronic renal disease and divided into 6 groups, and 30 healthy people were involved as control group. Urinary proteins and light chains were detected by immuonephelometry. ［Results］IgG, mAlb andTRF in no renal injury group (1) compared to healthy control (0) group, showed no significant differences (P>0.05). But other indicators in 2,3,4,5 and 6 groups compared to health control group, provided significant differences (P<0.05). Correlation analysis presented that all the indicators were highly correlated to the classification of urine proteins (P<0.05), and with the increased level of urinary protein (±to++++).Variability of the same indicator in different patients of same group also increased. ［Conclusion ］Levels of different proteins reflect the degree of different region of the kidney injury, and with increased levels of urinary proteins, variations of the same indicators in different patients of same group have increased. So appropriate therapeutic measures should be based on specific conditions.