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目的探讨尿微量白蛋白与尿肌酐比值及尿NAG检测在肾结石微创手术中的应用价值。方法选取2014年7月至2015年8月在我院泌尿外科住院的50例肾结石患者作为研究对象,为实验组,选择同期在本院进行体检的健康者50例作为对照组。实验组进行PCNL术,于术前、术后7天、30天分别留取新鲜晨尿,对照组于体检当天留取新鲜晨尿,均检测尿α1-MG、β2-MG、m Alb、NAG、TRF、Ig G及Cr,并计算尿NAG/Cr、m Alb/Cr比值。结果实验组术前α1-MG、β2-MG、m Alb、NAG、TRF及Ig G均明显高于对照组,差异有统计学意义(P<0.05)。实验组尿NAG/Cr、m Alb/Cr显著高于对照组,实验组术后7天尿NAG/Cr明显高于对照组,术后30天尿NAG/Cr明显低于术后7天,差异均有统计学意义(P<0.05);术后7天、30天分别与术前比较,差异无统计学意义(P>0.05)。术后7天、30天尿m Alb/Cr分别与术前比无显著差异。实验组手术前后7天的△NAG/Cr与△m Alb/Cr成正相关,手术前后30天的△NAG/Cr与△m Alb/Cr无相关性。结论尿m Alb与尿肌酐比值及尿NAG是反映早期肾功能损害的敏感指标,能够对早期肾功能损害做出诊断。
Objective To investigate the value of urine microalbumin to urinary creatinine and urine NAG detection in minimally invasive nephrolithotomy. Methods Fifty patients with nephrolithiasis hospitalized in urology from July 2014 to August 2015 in our hospital were chosen as the study subjects. Fifty healthy subjects who took physical examination in our hospital during the same period were selected as the control group. In the experimental group, fresh morning urine was collected preoperatively, 7 days and 30 days after operation, and fresh morning urine was collected on the day of examination in the control group. Urinary α1-MG, β2-MG, m Alb, NAG , TRF, Ig G and Cr, and calculated urine NAG / Cr, m Alb / Cr ratio. Results The preoperative α1-MG, β2-MG, m Alb, NAG, TRF and Ig G in the experimental group were significantly higher than those in the control group, with statistical significance (P <0.05). The urinary NAG / Cr and m Alb / Cr in the experimental group were significantly higher than those in the control group. Urinary NAG / Cr levels in the experimental group at 7 days after operation were significantly higher than those in the control group. Urinary NAG / Cr levels at 30 days after operation were significantly lower than those at 7 days after operation. (P <0.05). There was no significant difference between preoperative and postoperative days 7 and 30 (P> 0.05). There was no significant difference in urinary Alb / Cr at 7 days and 30 days after operation compared with that before operation. There was a positive correlation between △ NAG / Cr and △ m Alb / Cr at 7 days before and after operation in the experimental group. There was no correlation between △ NAG / Cr and △ m Alb / Cr at 30 days before and after operation. Conclusion The ratio of urine m Alb to creatinine and urinary NAG are sensitive indicators of early renal impairment, which can make a diagnosis of early renal dysfunction.