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学科主题: 肾脏病学
题名:
药物相关肾小管间质性肾炎患者几种尿标志物与肾脏病理的相关性
其他题名: Correlation between urinary biomarkers and pathological lesions in drug-induced tubulointerstitial nephritis
作者: 吴昱; 苏涛; 杨莉; 王辰; 刘刚; 李晓玫
关键词: 病理过程 ; 肾炎,间质性 ; 尿标志物 ; Pathological processes ; Nephritis,interstitial ; Urinary biomarkers
刊名: 中华内科杂志
发表日期: 2010
DOI: 10.3760/cma.j.issn.0578-1426.2010.07.006
卷: 49, 期:7, 页:568-571
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 通过对药物相关肾小管间质性肾炎(DTIN)患者尿标志物与临床病理相关性的研究,发现对DTIN病理改变有相关意义的尿标志物.方法 共40例肾活检确诊的DTIN患者和24例对照入选,取肾活检当日的尿标本,用双抗体夹心ELISA法检测转化生长因子β(TGFβ);放射性酶联免疫法检测IL-6;酶-底物直接显色法检测N-乙酰-β-氨基葡萄糖苷酶(NAG);免疫透射比浊法检测α1微球蛋白(α1-MG).同时对患者组的病理进行半定量评分,并构建受试者工作曲线(ROC),分析各尿液指标与病理损伤指标之间的相关性.结果 尿α1-MG与DTIN患者肾间质水肿、炎症细胞浸润和肾小管萎缩呈正相关,而尿IL-6与上述指标呈负相关;尿NAG与肾间质炎症细胞浸润和肾小管萎缩呈正相关;尿TGFβ与肾小管萎缩呈正相关;各尿标志物与肾间质纤维化均无相关性.ROC曲线分析结果显示:尿α1-MG鉴别肾间质炎性细胞浸润的ROC曲线下面积(AUC)大于NAG(0.797比0.734,P值<0.05),联合检测尿α1-MG和尿NAG能提高诊断的敏感性;而各标志物鉴别肾间质水肿和肾小管萎缩的AUC只有尿α1-MG有统计学意义(AUC=0.723,P=0.027;AUC=0.774,P=0.008).结论 尿α1-MG和NAG水平能反映肾间质炎症浸润的严重程度,二者联合检测能提高诊断的敏感性.尿α1-MG水平尚能反映肾间质水肿和肾小管萎缩程度. Objective To find some urinary biomarkers for differential diagnosis in drug-induced tubulointerstitial nephritis (DTIN) by accessing the relationship between their changes and the pathological processes of DTIN.Methods Forty patients biopsy-proven DTIN and 24 healthy controls were enrolled in this study.The urine samples of DTIN patients were collected on the day of biopsy and were measured for the following biomarkers: urinary TGF-β with enzyme-linked immunosorbent assay (ELISA);urinary IL-6 with radio-immunoassay;N-acetyl-β-D-glucosaminidase (NAG) with enzyme-substrate colorimetric assay;α1-microglobulin (α1-MG) with immune transmission turbidity method.Meanwhile, the pathological changes on renal biopsy were analyzed semi-quantitatively and scored.The relationship between these pathological changes and the urinary biomarkers were analyzed and receiver operating characteristic curve ( ROC curve) of those biomarkers in distinguishing different pathological lesions were constructed.Results Urinary α1- MG levels were positively correlated to interstitial edema, inflammatory cell infiltration and tubular atrophy, while urinary IL-6 were negatively correlated to the above parameters.Urinary NAG had positive relationship with inflammatory cell infiltration and tubular atrophy, while urinary TGF-β had positive relationship with tubular atrophy.ROC analysis results indicated that the area under curve (AUC) of α1-MG was larger than that of NAG (0.797 vs 0.734, P < 0.05 ).Combined measurement of α1-MG and NAG could enhance the sensitivity of detecting interstitial inflammatory cell infiltration.For detecting interstitial edema and tubular atrophy, only α1-MG had statistical significance ( AUC = 0.723, P = 0.027;AUC = 0.774, P = 0.008,respectively).Conclusions Urinary α1-MG and NAG levels can reflect the severity of interstitial inflammatory infiltration, combined measurement of both can enhance sensitivity.Urinary α1-MG level can also reflect the degree of interstitial edema and tubular atrophy.
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/400002259/46043
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: 卫生部肾脏疾病重点实验室,北京大学第一医院肾内科北京大学肾脏病研究所,100034

Recommended Citation:
吴昱,苏涛,杨莉,等. 药物相关肾小管间质性肾炎患者几种尿标志物与肾脏病理的相关性[J]. 中华内科杂志,2010,49(7):568-571.
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