Rector W G, Kanel G C, Rakela J, Reynolds T B
Hepatology. 1985 Mar-Apr;5(2):321-6. doi: 10.1002/hep.1840050229.
We examined beta 2-microglobulin (B2MG) excretion, an index of tubular function, in patients with hepatorenal syndrome, in whom tubular function is generally regarded as normal. Urine B2MG was significantly higher in these patients than in control patients with normal serum creatinine concentration. Patients with high urine B2MG concentration had markedly higher serum bilirubin than did patients with normal values (31 +/- 3 vs. 10 +/- 8 mg%, p less than 0.001), whereas prothrombin activity, serum albumin and serum B2MG concentration were similar. A "threshold" serum bilirubin concentration of about 23 mg% differentiated patients with normal and high urine B2MG values. Renal morphology at autopsy was unremarkable in both groups. Tubular dysfunction, manifested by increased urinary excretion of B2MG, occurs in patients with hepatorenal syndrome and deep jaundice. This measurement cannot, therefore, be used to make a diagnosis of acute tubular injury, as due to aminoglycosides, in such patients.
我们检测了肝肾综合征患者的β2-微球蛋白（B2MG）排泄情况，这是肾小管功能的一项指标，而在这类患者中，肾小管功能通常被认为是正常的。这些患者的尿B2MG显著高于血清肌酐浓度正常的对照患者。尿B2MG浓度高的患者血清胆红素明显高于正常值的患者（31±3 vs. 10±8mg%，p<0.001），而凝血酶原活性、血清白蛋白和血清B2MG浓度相似。约23mg%的“阈值”血清胆红素浓度可区分尿B2MG值正常和高的患者。两组患者尸检时的肾脏形态均无明显异常。肝肾综合征和深度黄疸患者存在以B2MG尿排泄增加为表现的肾小管功能障碍。因此，该测量方法不能用于诊断此类患者因氨基糖苷类药物导致的急性肾小管损伤。
