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许多实验室把尿总蛋白的测定列为“二类”分析项目,通常由不熟练的操作者进行分析,临床化学家也很少过问。然而多数方法的正常值和临床蛋白尿之间有严格的界线,操作马虎就会忽略蛋白尿潜在的病理重要性。正常人和病人尿蛋白成分在定性和定量方面都有变化。体位改变和运动可引起蛋白尿,肾小球、肾小管、非肾源性病变,乳糜尿,尿毒症病人可引起蛋白尿。目前测定尿蛋白的各种方法均有缺点,即对不同的病理情况可呈现不同的灵敏度。要凭“尿总蛋白”来确定疾病,至少必须包括30种不同来源的蛋白。而一种测定方法只能对一些蛋白较灵敏,对另一些则不大灵敏。为了寻找尿中总蛋白稳定和可靠的测定方法,作者评价了下列五种尿蛋白定量法:
Many laboratories rank urinary total protein determinations as “type 2” and are usually analyzed by unskilled operators, with little in the way of clinical chemists. However, there is a strict line between normality and clinical proteinuria in most methods, and sloppy manipulation ignores the underlying pathological importance of proteinuria. Urine protein components in both normal and patients vary qualitatively and quantitatively. Postural changes and exercise can cause proteinuria, glomerular, tubular, non-renal disease, chyluria, uremia patients can cause proteinuria. Currently, various methods for measuring urinary protein have disadvantages, that is, different sensitivities can be presented to different pathological conditions. The “total urinary protein” to determine the disease, at least must include 30 different sources of protein. However, one assay is sensitive to some proteins and less sensitive to others. In an effort to find a stable and reliable assay for urinary total protein, the authors evaluated the following five urinary protein quantitation methods: