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学科主题: 肾脏病学
题名:
几种尿标志物在急性药物性肾小管间质性肾炎鉴别诊断中的意义
其他题名: Significance of urinary biomarkers in differential diagnosis of acute tubulointersitial nephritis
作者: 吴昱; 苏涛; 杨莉; 王辰; 刘刚; 李晓玫
关键词: 乙酰氨基葡萄糖苷酶 ; α1微球蛋白 ; 肾炎 ; 间质性 ; 药物过敏 ; 诊断 ; 鉴别 ; Acetylglucosaminidase ; alphal-microglobulin ; Nephritis,interstital ; Drug hypersensitivi-ty ; Diagnosis differential
刊名: 北京大学学报(医学版)
发表日期: 2010
DOI: 10.3969/j.issn.1671-167X.2010.02.011
卷: 42, 期:2, 页:164-168
文章类型: Journal Article
摘要: 目的:通过对药物性肾小管间质性肾炎(DTIN)患者尿标志物I临床病理相关性的研究,发现对鉴别急性DTIN(A-DTIN)和慢性DTIN(C-DTIN)有意义的尿标志物.方法:共40例肾活检确诊的DTIN患者入选,取肾活检当日的尿标本,用双抗体夹心酶联免疫吸附(ELISA)法检测TGF-β,放射性酶联免疫法(RIA)检测IL-6,酶-底物直接显色法检测NAG,免疫透射比浊法检测α1-MG.通过构建受试者工作曲线(ROC)来计算各尿液指标鉴别A-DTIN的敏感性及特异性.结果:A-DTIN组的尿NAG和尿α1-MG分别是C-DTIN组的2.5和2.1倍(P值均<0.05),而尿TGF-β水平在A-DTIN组和C-DTIN组之间差异无统计学意义.尿α1-MG和NAG鉴别A-DTIN的曲线下面积分别为0.720(P=0.029)和0.714(P=0.034),而尿TGF-β的曲线下面积为0.536,无统计学意义(P=0.767),尿IL-6的曲线下面积为0.150(P=0.004).将尿α1-MG和NAG进行联合能使敏感性和特异性分别达到78.6%和75.0%.结论:尿α1-MG和NAG水平能反映DTIN的急性损伤,二者联合检测能提高鉴别诊断A-DTIN的效率. Objective:To find some urinary biomarkers with significance in the differentiation of drug-induced tubulointersitial nephritis(DTIN).Methods:Forty patients with biopsy-proven DTIN were en-rolled.The urine samples of DTIN patients were collected on the day of biopsy and all urine samples were measured for the following different biomarkers as indicated,respectively:urinary TGF-β by ELISA;uri-nary IL-6 by radio-immunoassay;NAG by an enzyme-substrate colorimetric assay:α1-MG by immune transmission turbidity method.Receiver operating characteristic curves (ROC curve) were constructed to calculate the sensitivity and specificity of those biomarkers in distinguishing acute (A-DTIN) and chronic DTIN(C-DTIN).Results:Urinary NAG and α1-MG levels in patients with A-DTIN were as 2.5 and 2.1 times as those in C-DTIN(P<0.05),while urinary TGF-β levels in the two groups had no statistical difference.The areas under ROC curve (AUC) of urinary NAG and α1-MG for differentiating A-DTIN were 0.720 (P=0.029) and 0.714 (P=0.034) respectively,while the AUCs for TGF-β and IL-6 were 0.536(P=0.767)and 0.150(P=0.004)respectively.Combined measurement of NAG and α1-MG could make sensitivity and specificity reach 78.6%and 75.0% respectively.Conclusion:Urinary αl-MG and NAG levels can reflect the acute lesions of DTIN,and combined measurement of both could en-hance efficiency in differentiating A-DTIN.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/46042
Appears in Collections:北京大学第一临床医学院_肾脏内科_期刊论文

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作者单位: 北京大学第一医院肾内科,北京大学肾脏病研究所,卫生部肾脏疾病重点实验室,北京,100034

Recommended Citation:
吴昱,苏涛,杨莉,等. 几种尿标志物在急性药物性肾小管间质性肾炎鉴别诊断中的意义[J]. 北京大学学报(医学版),2010,42(2):164-168.
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