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目的:探讨尿微量白蛋白(mALB)、视黄醇结合蛋白(RBP)和尿N-乙酰-β-d-氨基葡萄糖苷酶(NAG)检测对肝豆状核变性(HLD)早期肾脏损伤的诊断价值及其在不同类型HLD中测定值是否存在差异。方法:采用免疫比浊法检测尿mALB和RBP水平,采用连续监测法检测尿NAG水平。结果:各中医证型及西医临床分型HLD组尿mALB、RBP和NAG测定值均较正常对照组显著增高(P<0.01);而各中医证型及西医临床分型组组间mALB、RBP及NAG测定值比较,差异无统计学意义(P>0.05)。其在尿常规尿蛋白定性阴性HLD中阳性率分别为RBP94.74%、mALB78.07%和NAG35.09%。其中mALB与NAG呈正相关(r=0.26,P<0.01),mAL B与RBP水平呈正相关(r=0.232,P<0.01),NAG与RBP水平呈正相关(r=0.180,P<0.01)。结论:尿mALB、RBP和NAG检测对HLD早期肾损害具有诊断价值,其中RBP阳性率最高达94.74%。HLD各中医证型与西医临床分型间尿mALB、RBP和NAG水平无明显差异。
OBJECTIVE: To investigate the effects of mALB, RBP and NAG on the early renal damage of hepatodenticular degeneration (HLD) The diagnostic value and its differences in the measured values in different types of HLDs. Methods: The levels of urinary mALB and RBP were detected by immunoturbidimetry. Urinary NAG levels were measured by continuous monitoring. Results: The values of mALB, RBP and NAG in HLD group were significantly higher than those in normal control group (P <0.01), while the levels of mALB, RBP And NAG measured values, the difference was not statistically significant (P> 0.05). The positive rate of urinary routine proteinuria negative HLD were 94.74% of RBP, 78.07% of mALB and 35.09% of NAG. There was a positive correlation between mALB and NAG (r = 0.26, P <0.01). There was a positive correlation between mALB and RBP (r = 0.232, P <0.01) and NAG and RBP (r = 0.180, P <0.01). Conclusion: The detection of urinary mALB, RBP and NAG have diagnostic value for early renal damage in HLD, and the positive rate of RBP is up to 94.74%. There was no significant difference in urine mALB, RBP and NAG levels between HLD TCM syndromes and Western clinical classification.