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目的探讨尿液足细胞标志蛋白Podocalyxin(PCX)检测对血尿患儿的临床诊断价值。方法采用透射比浊法对210例儿童清晨首次尿标本足细胞标志蛋白PCX进行检测,其中包括肾小球源性血尿患儿78例(肾小球源性血尿组)、非肾小球源性血尿患儿66例(非肾小球源性血尿组),以及66例健康儿童(健康对照组)。采用透射比浊法对78例肾小球源性血尿组患儿同期尿清蛋白水平进行检测。采用速率法对78例肾性血尿患儿同期血清清蛋白、胆固醇、尿素氮及肌酐水平进行检测。结果 1.肾小球源性血尿组尿PCX为(16.48±18.95)μg·L-1,非肾小球源性血尿组为(1.85±2.91)μg·L-1,健康对照组为(1.69±2.12)μg·L-1,肾小球源性血尿组与非肾小球源性血尿组及健康对照组比较,尿PCX水平明显升高,差异均有统计学意义(Pa<0.05);非肾小球源性血尿组与健康对照组比较,差异无统计学意义(P>0.05)。2.PCX水平检测与尿流式细胞检测结果在判断血尿来源方面一致性较好(Kappa=0.647,P<0.01)。3.PCX曲线下面积(ROC)=0.909(P<0.01),诊断准确性较高,诊断截点为5.73μg·L-1。4.肾小球源性血尿组尿PCX水平与尿蛋白水平呈正相关(r=0.465,P<0.01),与血清清蛋白水平呈负相关(r=-0.736,P<0.01),与血胆固醇水平呈正相关(r=0.671,P<0.01),与血尿素氮水平呈正相关(r=0.309,P<0.01),与血肌酐水平无相关性。结论尿PCX水平检测可作为临床判断肾小球源性与非肾小球源性血尿、肾小球损伤严重程度及病情活动与缓解的一个较好指标。
Objective To investigate the clinical diagnostic value of urinary podocyte marker protein Podocalyxin (PCX) in children with hematuria. Methods The turbidimetric method was used to detect podocyte marker protein PCX in 210 cases of early urine samples from early childhood, including 78 cases of glomerular hematuria (glomerular hematuria group), non-glomerular 66 cases of hematuria (non-glomerular hematuria group), and 66 healthy children (healthy control group). Urinary albumin levels were measured in 78 children with glomerular hematuria during the same period by transmission turbidimetry. The rate of serum albumin, cholesterol, urea nitrogen and creatinine in 78 cases of renal hematuria were detected by the rate method. Urine PCX was (16.48 ± 18.95) μg · L-1 in glomerular hematuria group, (1.85 ± 2.91) μg · L-1 in non-glomerular hematuria group and (1.69 ± 2.91) μg · L- ± 2.12) μg · L-1. Compared with non-glomerular hematuria group and non-glomerular hematuria group, urinary PCX levels were significantly increased (P0.05) Non-glomerular hematuria group and healthy control group, the difference was not statistically significant (P> 0.05). The consistency of PCX level and uroflow cytometry in judging the origin of hematuria is better (Kappa = 0.647, P <0.01). The area under the curve of PCX (ROC) was 0.909 (P <0.01), and the diagnostic accuracy was high, with a diagnostic cutoff of 5.73μg · L-1.4. The urinary PCX levels in glomerular hematuria group were significantly correlated with urinary protein levels (R = -0.736, P <0.01), positively correlated with the level of serum cholesterol (r = 0.671, P <0.01), and positively correlated with blood urea nitrogen Nitrogen levels were positively correlated (r = 0.309, P <0.01), and had no correlation with serum creatinine. Conclusion Urine PCX levels can be used as a good indicator to judge glomerular and non-glomerular hematuria, severity of glomerular injury and disease activity and remission.