联合检测血胱抑素C及尿微量蛋白在评估体外冲击波碎石肾损伤中的作用

摘要

Objective In order to explored early renal damage and the severity induced by extracorporeal shock wave lithotrip-sy for the treatment of renal calculi,we detected serum cystatin C (Cys C) combined with urinary albumin AlbU、urinary transferrin TRFU、urinary immunoglobulin IgGU、urinaryα1-microglobulinα1MU which were considered to be sensitive index of renal dam-age. Methods The levels of serum Cys C and urine AlbU、urine TRFU、urine IgGU、urineα1MU were sequentially measured in 30 patients with renal stones who accepted extracorporeal shock wave lithotripsy. Before treatment samples were obtained and after-wards at days+3,+5,+7,+15. The test results were analyzed statistically. Results The levels of serum Cys C and urinary albumin AlbU、urinary transferrin TRFU,urinary immunoglobulin IgGU、urinaryα1-microglobulinα1MU at days+1,+3 after extracorporeal shock wave lithotripsy were higher than that before treatment (P<0.05). The levels of serum Cys C and urinary albumin AlbU、uri-nary transferrin TRFU、urinary immunoglobulin IgGU,urinary α1-microglobulin α1MU at days +5 after extracorporeal shock wave lithotripsy were decreased gradually,and+7 after extracorporeal shock wave lithotripsy,there was no difference with the levels be-forehand. The incidence rare of renal damage after extracorporeal shock wave lithotripsy of serum cystatin C (Cys C) was higher than that of other groups,but lower than that of detection of serum Cys C combined with urine AlbU、urine TRFU、urine IgGU、urine α1MU (P≤0.05). Conclusion extracorporeal shock wave lithotripsy for renal stones may made early renal damage,but the damage was low. Detection of serum Cys-C combined with urinary albumin AlbU、urinary transferrin TRFU、urinary immunoglobu-lin IgGU、urinary α1MU in patients with early renal damage induced by extracorporeal shock wave lithotripsy was helpful to early diagnosis.%目的：通过联合检测血清胱抑素C（Cys C）和尿微量白蛋白AlbU，尿转铁蛋白TRFU，尿免疫球蛋白IgGU，尿α1微球蛋白α1MU这2大项对早期肾功能损害敏感的指标，探讨体外冲击波碎石治疗肾结石对肾造成的早期损伤及损伤程度。方法选取体外冲击波碎石治疗的肾结石病例30例，分别于治疗前，治疗后第1、3、5、7、15d联合检测血清Cys C及尿AlbU，尿TRFU，尿IgGU，尿α1MU，并对检测结果进行统计分析。结果碎石后1、3d血清Cys C及尿AlbU，尿TRFU，尿Ig-GU，尿α1MU水平比碎石前有升高（P均＜0.05），碎石5d后血清Cys C及尿AlbU，尿TRFU，尿IgGU，尿α1MU水平逐步下降，7d后与碎石前已无差异。碎石后肾功能异常发生率以血清Cys C组为最高，但低于联合检测血清Cys C及尿AlbU，尿TRFU，尿IgGU，尿α1MU组肾功能异常阳性率（P≤0.05）。结论体外冲击波碎石治疗肾结石会对肾造成早期损害，但损害程度较轻。联合检测可以提高对该损害的检出阳性率并具有重要意义。