天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (10): 1197-1200.doi: 10.11958/j.issn.0253-9896.2015.10.030

• 诊断技术 • 上一篇    下一篇

联合检测 PTH、 β2-MG 及 hs-CRP 在鉴别诊断急、 慢性#br# 肾功能衰竭中的价值

  

  1. 四川省人民医院城东病区检验科 （邮编 610101）
  • 收稿日期:2015-02-28 修回日期:2015-05-11 出版日期:2015-10-15 发布日期:2015-10-22
  • 基金资助:
    国家高技术研究发展计划（863计划）

The value of combined detection of PTH, β2-MG and hs-CRP in differentiating#br# diagnosis of acute and chronic renal failure

  1. The East Ward Laboratory of Sichuan Provincial People′s Hospital,Chengdu 610101,China
  • Received:2015-02-28 Revised:2015-05-11 Published:2015-10-15 Online:2015-10-22

PDF (PC)

3981

摘要： 摘要:目的 探讨联合检测甲状旁腺素 （PTH）、 β2-微量球蛋白 （β2-MG） 及超敏 C 反应蛋白 （hs-CRP） 对急性肾功
能衰竭（ARF）和慢性肾功能衰竭（CRF）的鉴别诊断价值。方法 138 例肾功能衰竭（RF）患者分为 ARF 组 64 例，
CRF 组 74 例。同时选取其他非肾功能衰竭的肾病 （NRF） 组 80 例和健康对照组 80 例， 检测并比较 4 组的 PTH、 β2-
MG 及 hs-CRP 水平， 串联分析各组合 （PTH+β2-MG、 PTH+hs-CRP、 β2-MG+hs-CRP 及 PTH+β2-MG+hs-CRP） 的诊断
效率， 选择适合诊断 ARF 和 CRF 的最优组合。结果 ARF 组的 hs-CRP 高于 CRF 和对照组， PTH 及β2-MG 低于
CRF 组（P＜0.01）， 而 PTH 与对照组差异无统计学意义。CRF 组的 PTH 及β2-MG 显著高于对照组,而 hs-CRP 与对
照组无统计学意义。ARF 患者 hs-CRP 及β2-MG 多中度+重度升高（68.7%和 81.2%）并伴 PTH 轻度升高（25.0%），
CRF 患者 PTH 及β2-MG 多中度+重度升高（56.8%和 98.6%）并伴 hs-CRP 轻度+中度升高（39.2%）。β2-MG 及 hsCRP 可明显提高 ARF 的总符合率（TCR）及 Youden 指数（YI）， PTH 及β2-MG 可明显提高 CRF 的 TCR 及 YI。结
论 联合检测 PTH、 β2-MG 及 hs-CRP 有助于 ARF 与 CRF 的鉴别诊断。

关键词: 甲状旁腺素, β2-微量球蛋白, 超敏 C 反应蛋白, 肾功能衰竭, 鉴别诊断

Abstract:

Abstract： Objective To explore the value of combined detection of parathyroid hormone（PTH） , β2-microglobulin （β2-
MG）and high sensitivity C-reactive protein（hs-CRP） in differentiating diagnosis of acute and chronic renal failure. Meth⁃
ods Patients diagnosed with renal failure was divided into acute renal failure patients group (n=64) and chronic renal fail⁃
ure group (n=74) . Other patients with non-renal failure kidney disease (NRF group, n=80) and healthy adult (control group,
n=80) were also selected. Levels of PTH, β2-MG, hs-CRP , PTH+β2-MG, PTH+hs-CRP, β2-MG+ hs-CRP and PTH+β2-
MG+ hs-CRP were compared between these four groups to choose the optimal combination for differential diagnosis. Re⁃
sults Hs- CRP in ARF group was significantly higher than that in control group and CRF group. Levels of PTH and β2-
MG were significantly lower in ARF group than that in CRF groups but not in control group (P < 0.01). hs- CRP and β2-
MG in the ARF group were moderately higher (68.7%) and severely higher (81.2%) while PTH was mild higher (25%) in
ARF group than those in control group, On the other hand, hs-CRP and β2-MG in the ARF group were moderately higher
(56.8%) and severely higher (98.6%) while PTH was mild higher (39.2%) in ARF group than those in control group. Combina⁃
tion of hs-CRP with β2-MG could increase total case rate (TCR) and Youden index (YI) of ARF; while combination of PTH
and β2-MG could improve the TCR and YI of CRF. Conclusion Combined detection of PTH, β2-MG and hs-CRP is use⁃
ful in differential diagnosis of ARF and CRF.

Key words: parathyroid hormone, β2-microglobulin, high sensitivity C-reactive protein, renal failure, differential diagnosis