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[β2微球蛋白在儿童反流性肾病诊断中的应用]

[Beta 2 microglobulin in the diagnosis of reflux nephropathy in childhood].

作者信息

Salvaggio E, Menonna N M, Ricci R, Ferrara P, Nardini F

机构信息

Isituto di Clinica Pediatrica, Università Cattolica, Roma, Italia.

出版信息

Pediatr Med Chir. 1988 Jan-Feb;10(1):83-8.

PMID:3287353
Abstract

The authors determined beta 2 microglobulin plasmatic and urinary levels in 35 children aged 1 month-14 years; 25 of them were suffering from reflux nephropathy. The results of this study indicate that B2 microglobulin concentrations in plasma and urine can be useful parameters to the clinical diagnosis and evaluation of severity of reflux nephropathy. In presence of reduced glomerular filtration rate B2 microglobulin plasmatic levels resulted significantly out of the normal range (mean = 3318; s.d. = 1184) and proportional to the residual functionality degree (p 0.005); blood B2 microglobulin values demonstrated a higher specificity (76.2%) than creatine clearance. Moreover Bt (B2 microglobulin urinary level), Bs (B2 microglobulin excretion per minute corrected to surface area) and Bf (B- microglobulin excretory fraction) were shown to vary (p 0.025) in relation to the presence and the degree of tubulo-interstitial damage. In particular, Bf values progressively impairing with the severity of the nephropathy, were shown to have a statistically good distribution and the best sensibility (95.2%) and specificity (77.8%) in detecting tubular damage.

摘要

作者测定了35名年龄在1个月至14岁儿童的血浆和尿液中β2微球蛋白水平;其中25名患有反流性肾病。该研究结果表明,血浆和尿液中的β2微球蛋白浓度可作为反流性肾病临床诊断和严重程度评估的有用参数。在肾小球滤过率降低的情况下,血浆β2微球蛋白水平显著超出正常范围(平均值 = 3318;标准差 = 1184),且与残余功能程度成正比(p < 0.005);血液β2微球蛋白值显示出比肌酐清除率更高的特异性(76.2%)。此外,尿液β2微球蛋白水平(Bt)、每分钟经体表面积校正的β2微球蛋白排泄量(Bs)和β2微球蛋白排泄分数(Bf)显示出与肾小管间质损伤的存在和程度相关的变化(p < 0.025)。特别是,Bf值随着肾病严重程度逐渐受损,在检测肾小管损伤方面显示出具有统计学意义的良好分布以及最佳敏感性(95.2%)和特异性(77.8%)。

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