Rupprecht H D
Nephrologisches Zentrum, Medizinische Poliklinik Klinikum der Universität München, Innenstadt.
MMW Fortschr Med. 2004 Oct 21;146(43):41-5.
Normally, protein secretion in the urine is less than 150 mg/day or less than 100 mg/g creatinine. Orthostatic proteinuria, proteinuria in the presence of fever, and effort proteinuria are benign forms. In cases of persistent proteinuria, prerenal or overflow proteinuria are distinguished from renal and post-renal proteinuria. Renal forms can be differentiated into glomerular and tubular as well as mixed forms. The urine dipstick is of only low sensitivity, and is therefore unsuitable as a screening test for diabetic microalbuminuria. In addition, it cannot detect immunoglobulin light chains in Bence Jones proteinuria. For the differentiation between glomerular and tubular forms of proteinuria, the determination of marker proteins in the urine, for example, alpha1 microglobulin, albumin and IgG, has proven utility.
正常情况下,尿蛋白分泌量每天少于150毫克或每克肌酐少于100毫克。直立性蛋白尿、发热时出现的蛋白尿和运动性蛋白尿均为良性类型。在持续性蛋白尿的情况下,需将肾前性或溢出性蛋白尿与肾性及肾后性蛋白尿区分开来。肾性蛋白尿可分为肾小球性、肾小管性以及混合性。尿试纸条的敏感性较低,因此不适合作为糖尿病微量白蛋白尿的筛查试验。此外,它无法检测本周蛋白尿中的免疫球蛋白轻链。对于区分肾小球性和肾小管性蛋白尿类型,测定尿中的标志物蛋白,例如α1微球蛋白、白蛋白和IgG,已被证明具有实用价值。