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目的 :探讨测定尿液甘氨酰脯氨酸二肽氨基肽酶 (Glycyl- proline dipeptidyl aminopeptidase,GPDA)水平 ,在肾脏炎症与下尿路感染的鉴别价值。方法 :采用连续监测法和速率法检测泌尿系感染者的尿液 GPDA及尿肌酐(Cr)水平 ,并用 U/g.Cr的单位表示酶活性单位。通过 ROC曲线特性分析尿液 GPDA在泌尿系感染鉴别肾脏炎症时的临界值。结果 :1肾脏炎症组尿液 GPDA水平高于对照组 ,也高于下尿路感染组 ;肾脏炎症组阳性率显著高于下尿路感染患者 (χ2 =4 2 .92 8,P<0 .0 1)。提示 :检测尿液 GPDA对肾脏炎症与下尿路感染有鉴别价值。2在 ROC曲线上 ,临床的 GPDA最佳临界值 (Cutoff point)为 2 1.4 U/g.Cr。敏感性为 84 .6 % (33/39) ,特异性为 88.1% (37/42 ) ,阳性预测值为 86 .8% (33/38) ,阴性预测值 86 .1% (37/43) ,准确度 86 .4 % (70 /81)。以 2 1.4 U/g.Cr为鉴别限时 ,可以较好的筛选肾脏炎症患者。结论 :检测泌尿系感染患者尿 GPDA水平 ,对肾脏炎症和下尿路感染的定位鉴别诊断 ,提供一定的诊断价值 ,也有利于指导治疗。
Objective: To investigate the value of urinary glycyl proline dipeptidyl aminopeptidase (GPDA) in the differential diagnosis of renal inflammation and lower urinary tract infection. Methods: The urinary GPDA and urinary creatinine (Cr) levels in urinary tract infection patients were detected by continuous monitoring and rate method. The units of enzyme activity were expressed in units of U / g.Cr. The critical value of urinary GPDA in urinary tract infection to identify renal inflammation was analyzed by ROC curve characteristics. Results: 1 The urinary GPDA level in renal inflammation group was higher than that in control group and lower urinary tract infection group. The positive rate in renal inflammation group was significantly higher than that in lower urinary tract infection group (χ2 = 42.292, P <0. 0 1). Tip: Detection of urine GPDA on the differential diagnosis of renal inflammation and lower urinary tract infection. 2 On the ROC curve, the clinical critical GPDA cutoff point is 2 1.4 U / g.Cr. The sensitivity was 84.6% (33/39), the specificity was 88.1% (37/42), the positive predictive value was 86.8% (33/38), the negative predictive value was 86.1% (37/43) , The accuracy of 86.4% (70/81). To 2 1.4 U / g.Cr for the identification of limited time, you can better screening of patients with kidney inflammation. Conclusion: The detection of urinary GPDA levels in patients with urinary tract infection, differential diagnosis of renal inflammation and lower urinary tract infection, to provide some diagnostic value, but also conducive to guiding treatment.