血清胱抑素 C、β2微球蛋白与尿酸联合检测对结核治疗后早期肾损害的诊断价值

摘要

目的：通过联合检测肺结核（PTB）患者抗结核治疗后血清中胱抑素C（CysC）、β2微球蛋白（β2‐MG）与尿酸（U A ）水平的变化，评价其在抗结核治疗后早期肾损害中的临床价值。方法：采用胶乳增强免疫比浊法测定120例肺结核患者治疗前及治疗后血清中CysC、β2‐MG水平，同时采用酶法测定血清尿酸、尿素（Urea）肌酐（Cr），并对120例患者治疗前与治疗后测定结果进行比对分析。结果：抗结核治疗后PTB患者血清中CysC、β2‐MG、UA水平显著高于治疗前，差异有统计学意义（P＜0．01），血清Urea、Cr水平治疗前、后差异无统计学意义（P＞0．05）。治疗后检测Cy‐sC升高异常率为58．3％、β2‐M G为54．2％、U A为50．8％，三项联合检测升高异常率为82．5％，显著高于各单项组（P＜0．01）。治疗后血清CysC、β2‐MG水平与UA水平呈显著正相关（P＜0．01）。结论：肺结核患者抗结核治疗后血清CysC、β2‐MG水平呈现升高，并且与UA水平有良好的相关性。三者联合检测更能反映患者抗结核治疗肾功能的早期损伤情况，对临床早期诊断治疗、指导用药有着良好的实用价值和意义。%Objective :To evaluate the clinical value of change of serum cystatin C (CysC) ,serumβ2‐microglobulin(β2‐MG) ,and uric acid (UA) in pulmonary tuberculosis patients (PTB) with early renal damage after treatment .Methods :Serum CysC ,serum β2‐MG ,serum UA ,serum Urea ,serum creatinine (Cr) were detected and compared in 120 pulmo‐nary tuberculosis patients before and after treatment .The first two items were detected by the Latex‐enhanced immu‐noturbidimetric assay ,and the latter three were tested with the enzymatic method .Results:Level of serum CysC ,serumβ2‐MG ,and serum UA in pulmonary tuberculosis patients after treatment was significantly greater than the level before treatment ,a statistically significant difference (respectively ,P<0 .01) ,while the difference of serum Urea and serum Cr in patients before and after treatment was not statistically significant (P>0 .05) .Level of serum CysC ,serumβ2‐MG ,and serum UA in patients after treatment were all increased ,and the abnormality rate was 58 .3% ,54.2% ,and 50 .8% ,respectively .Then the abnormality of the three joint detection was 82 .5% ,which was significantly higher than the single item (P<0 .01) .Level of serum CysC and serum β2‐MG were significantly positively related to the level of serum UA (P<0 .01) .Conclusion:Level of serum CysC and serum β2‐MG increased in pulmonary tuberculosis patients after antituberculous therapy ,and were positively relate to the level of serum UA .Joint detection of the above three i‐tems could more reflect the early renal damage in pulmonary tuberculosis patients after treatment ,which has good prac‐tical value and significance to the early clinical diagnosis and therapy and the medication guide .