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目的探讨血清肌红蛋白(Mb)和β2-微球蛋白(β2-MG)对慢性心力衰竭(CHF)患者肾功能损害的评价及其临床意义。方法用放射免疫法测定了120例CHF患者和40例对照组的血清Mb和β2-MG水平,生化法测定血肌酐(Cr)和尿素氮(BUN),并进行对照统计分析。结果CHF组血清Mb、β2-MG、Cr和BUN水平均显著高于对照组,分别为t=9.403,P<0.01;t=10.48,P<0.01;t=2.290,P<0.05;t=2.698,P<0.05,Mb和β2-MG相互间呈正相关(P<0.01),且均与Cr水平呈正相关(P<0.01)。在Ⅱ、Ⅲ、Ⅳ级组间,血清Mb、β2-MG、Cr和BUN水平均依次递增(方差F检验:F=9.180,P<0.01;F=12.39,P<0.01;F=5.048,P<0.05;F=6.429,P<0.05),住院死亡组血清Mb和β2-MG水平显著高于好转出院组(t=2.620,t=3.000.P<0.05)。结论CHF患者血清Mb和β2-MG、Cr和BUN水平显著升高,Mb与β2-MG相互成正相关,且均与Cr相关,住院死亡组Mb和β2-MG水平升高更显著。
Objective To evaluate the clinical significance of serum myoglobin (Mb) and β2-microglobulin (β2-MG) on renal dysfunction in patients with chronic heart failure (CHF). Methods Serum levels of Mb and β2-MG were measured in 120 patients with CHF and 40 controls by radioimmunoassay. Serum creatinine (Cr) and blood urea nitrogen (BUN) were measured by biochemical methods and compared statistically. Results The levels of serum Mb, β2-MG, Cr and BUN in CHF group were significantly higher than those in control group (t = 9.403, P <0.01; t = 10.48, P <0.01; , P <0.05, Mb and β2-MG were positively correlated with each other (P <0.01), and were positively correlated with Cr level (P <0.01). The levels of serum Mb, β2-MG, Cr and BUN increased gradually in the groups of Ⅱ, Ⅲ and Ⅳ (variance F test: F = 9.180, P <0.01; F = 12.39, P <0.01; F = 5.048, P <0.05; F = 6.429, P <0.05). Serum Mb and β2-MG levels in hospitalized death group were significantly higher than those in the discharged hospital group (t = 2.620, t = 3.000, P <0.05). Conclusion The serum levels of Mb and β2-MG, Cr and BUN in CHF patients were significantly increased, Mb and β2-MG were positively correlated with each other, and both were correlated with Cr. Mb and β2-MG levels were significantly higher in hospitalized death patients.