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[目的]探讨检测有机磷中毒患者尿白蛋白和尿β-2微球蛋白的临床意义。[方法]选择某院2008年1月～2010年11月收治的35例有机磷中毒患者作为研究对象,另选正常健康体检者30例作为对照组,β2-MG检测使用美国雅培公司提供的AXSYM化学发光仪,采用微粒子酶免(MEIA)法进行检测。尿白蛋白检测采用黄金标记目测免疫测定法,使用德国宝灵曼公司生产的尿微白蛋白试条(Micral-TestⅡ)进行测定。[结果]中毒后1d检测两组患者的尿白蛋白和尿β2微球蛋白的含量发现,尿β微球蛋白、尿白蛋白含量均较正常对照组升高明显(P﹤0.05,P﹤0.01),且随着中毒程度的加重,尿β微球蛋白、尿白蛋白含量增高更明显(P﹤0.05)。有机磷中毒患者血清CK、CK-MB、LDH及cTnI均明显高于正常对照组(P﹤0.05)。[结论]联合检测有机磷中毒患者的尿白蛋白和尿β2微球蛋白,及同时检测心肌酶谱与肌钙蛋白,有助于早期发现肾损害及中毒程度,提高抢救成功率和判断预后。
[Objective] To investigate the clinical significance of urinary albumin and urinary β-2 microglobulin in patients with organophosphate poisoning. [Methods] A total of 35 patients with organophosphate poisoning admitted to our hospital from January 2008 to November 2010 were enrolled in this study. Thirty patients with normal healthy subjects were selected as control group. Β2-MG was detected by AXSYM Chemiluminescence instrument, using microparticle enzyme immunoassay (MEIA) method for testing. Urine albumin detection using gold labeled visual immunoassay, the use of German Baumen Man produced urine micro-albumin test strips (Micral-Test Ⅱ) were measured. [Results] The contents of urinary albumin and urinary β2 microglobulin in both groups detected on day 1 after poisoning showed that the levels of urinary β-microglobulin and urinary albumin were significantly higher than those in normal control group (P <0.05, P <0.01) ), And with the aggravation of poisoning, urinary β-microglobulin and urinary albumin increased more significantly (P <0.05). Patients with organophosphate poisoning serum CK, CK-MB, LDH and cTnI were significantly higher than the normal control group (P <0.05). [Conclusions] Combined detection of urinary albumin and urine β2 microglobulin in patients with organophosphate poisoning and the simultaneous detection of myocardial enzymes and troponin are helpful to detect early renal damage and poisoning, improve the success rate of rescue and prognosis.