应用免疫浊度法在自动分析仪上测定了尿中微量白蛋白.对140名健康人一次尿样品测定后求出排出率的参考范围(可信区间95%),上限为2.83g/mol肌酐.此法结合尿中N-乙酰-β-D-氨基葡萄糖苷酶(NAG)测定应用于糖尿病和高血压患者以检测早期肾损伤.结果表明此法能灵敏地检出早期的尿中白蛋白漏出,对肾损伤早期诊断比传统的尿蛋白试验更为可靠.尿中溶酶体酶(如NAG)对肾小管损伤是更特异和灵敏的标志物.联合应用尿中微量白蛋白和酶的测定可进一步提高检出率,获得更有价值的信息.同时用血清Ⅳ型胶原测定对糖尿病人作了观察,结果糖尿病人血清Ⅳ型胶原均值也明显高于健康人对照组.这一指征反映了肾单位基底膜胶原蛋白的合成动态.
Urinary microalbumin was detected by an autoanalyzer with the method of immunoturbidimetry. The spot urine samples from a group of 140 healthy subjects were determined to establish a reference range of urinary microalbumin excretion rate(confidence interval 95%)and its upper limit was 2.83 g/mol creatinine. This assay and the urinary enzyme(N-acetyl-beta-D-glucosaminidase,NAG)determination were applied in the patients with diabetes mellitus and with hypertension for detecting the incipient nephrological changes. The results showed that this index was sensitive to detect the early elevation of albumine excretion in urine and has been proven to be a more valuable diagnostic tool in the early diagnosis of renal damage than the tradtional urine protein test. As the urinary lysosome enzyme (e.g.NAG) is more specific and sensitive marker of renal tubular injury. it is suggested to combine the microalbumin and the enzyme assays to yield more valuable informations. The serum type Ⅳ collagen determination with the enzyme immunoassay was performed simultaneously in the same group of patients with diabetes mellitus. It was found that the mean value of serum type Ⅳ collagen was higher than that of the control group. This index indicated the dynamic process of collagen peptide synthesis occurred in the basement membrane.
魏有仁,侯林浦,王玫,湛玉良,朱立华.尿中微量白蛋白的测定及应用[J].生物化学与生物物理进展,1995,22(2):169-173
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