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使用十二烷基硫酸钠-琼脂糖凝胶电泳评估定性蛋白尿的诊断相关性及其与犬肾组织学检查结果的比较

Diagnostic relevance of qualitative proteinuria evaluated by use of sodium dodecyl sulfate-agarose gel electrophoresis and comparison with renal histologic findings in dogs.

作者信息

Zini Eric, Bonfanti Ugo, Zatelli Andrea

机构信息

Department of Animal Pathology, Faculty of Veterinary Medicine, Via Leonardo da Vinci 44, 10045 Grugliasco (To), Italy.

出版信息

Am J Vet Res. 2004 Jul;65(7):964-71. doi: 10.2460/ajvr.2004.65.964.

Abstract

OBJECTIVE

To evaluate results of SDS-agarose gel electrophoresis (AGE) of urinary proteins for use in defining glomerular and tubulointerstitial derangements, investigate patterns of high-molecular-weight (HMW) proteins for differentiating among glomerular disorders, and assess low-molecular-weight (LMW) proteins as markers of severity of tubulointerstitial disease in dogs.

ANIMALS

49 dogs with increased serum creatinine concentrations or abnormal renal protein loss.

PROCEDURE

Urinary proteins were examined by use of SDS-AGE and differentiated on the basis of molecular weight. The HMW proteins (> or = 69 kd) were considered indicative of glomerular origin, whereas LMW proteins (< 69 kd) were of tubular origin. Renal specimens were examined by use of light microscopy. Glomerular and tubulointerstitial lesions were differentiated by use of the classification for the World Health Organization and semiquantitative grading, respectively.

RESULTS

Sensitivity of SDS-AGE was 100% for detection of glomerular lesions and 92.6% for tubulointerstitial lesions; specificity was 40% and 62.5%, respectively. Although HMW urinary proteins were not significantly associated with the type of glomerular lesion, LMW urinary proteins were significantly associated with the grade of tubulointerstitial damage. Detection of 12- or 15-kd proteins or both was highly indicative of a severe tubulointerstitial lesion.

CONCLUSIONS AND CLINICAL RELEVANCE

SDS-AGE of urinary proteins in dogs represents a noninvasive test with high sensitivity for identifying glomerular and tubulointerstitial damage, but low specificity limits its validity as a stand-alone test to differentiate between glomerular and tubulointerstitial lesions. The test is particularly useful for identifying dogs with advanced tubulointerstitial disease but cannot be used to characterize glomerular disorders.

摘要

目的

评估用于定义肾小球和肾小管间质紊乱的尿蛋白十二烷基硫酸钠-琼脂糖凝胶电泳(AGE)结果,研究高分子量(HMW)蛋白模式以区分肾小球疾病,并评估低分子量(LMW)蛋白作为犬肾小管间质疾病严重程度的标志物。

动物

49只血清肌酐浓度升高或肾蛋白丢失异常的犬。

方法

采用SDS-AGE检测尿蛋白,并根据分子量进行区分。HMW蛋白(≥69 kd)被认为提示肾小球来源,而LMW蛋白(<69 kd)提示肾小管来源。使用光学显微镜检查肾脏标本。分别采用世界卫生组织分类和半定量分级来区分肾小球和肾小管间质病变。

结果

SDS-AGE检测肾小球病变的敏感性为100%,检测肾小管间质病变的敏感性为92.6%;特异性分别为40%和62.5%。尽管HMW尿蛋白与肾小球病变类型无显著相关性,但LMW尿蛋白与肾小管间质损伤程度显著相关。检测到12-kd或15-kd蛋白或两者均检测到高度提示严重的肾小管间质病变。

结论及临床意义

犬尿蛋白的SDS-AGE是一种无创检测方法,对识别肾小球和肾小管间质损伤具有高敏感性,但低特异性限制了其作为区分肾小球和肾小管间质病变的独立检测方法的有效性。该检测方法对识别晚期肾小管间质疾病的犬特别有用,但不能用于描述肾小球疾病。

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