摘要
对８６例心力衰竭（心衰）患者血、尿β_２微球蛋白和Ｔａｍｍ－Ｈｏｒｓｆａｌｌ蛋白测定结果表明，心衰患者血β_２微球蛋白增高，β_２微球蛋白清除率降低，重度心衰时尿β_２微球蛋白也增高，但β_２微球蛋白排泄分数无改变。血β_２微球蛋白与尿素氮呈正相关、与肌酐清除率呈负相关，而β_２微球蛋白清除率恰与之相反。血、尿Ｔａｍｍ－Ｈｏｒｓｆａｌｌ蛋白随心衰程度的加重而降低。心衰改善后血β_２微球蛋白降低、β_２微球蛋白清除率增高，血、尿Ｔａｍｍ－Ｈｏｒｓｆａｌｌ蛋白也增高。提示血、尿β_２微球蛋白和Ｔａｍｍ－Ｈｏｒｓｆａｌｌ蛋白测定可作为心衰时判断肾功能损害及评价心衰程度的指标。
Serum and urine beta_2-microglobulin (β_2M) and Tamm-Horsfall protein (THP) levels were determined by radioimmunoassay in 86 patients with congestive heart failure and 21 normals. The results showed that serum β_2M levels were much higher, but β_2M clearance (Cβ_2M) was lower in patients with class Ⅱ or more severe,and urine β_2M levels were higher in class Ⅳ heart failure than those in normals. Fractional excretion of filtered β_2M (FE β_2M) had no significant difference between patients and normals. The more severe the heart failure, the higher the β_2M levels in serum and urine and the lower the Cβ_2M. Serum β_2M levels positively correlated with serum urea nitrogen (BUN) and negatively correlated with creatinine clearance (Ccr), on the contrary, Cβ_2M negatively correlated with BUN and positively correlated with Ccr in patients with class Ⅱ or mores severe heart failure. Serum THP levels in patients with class Ⅱ or more severe, and urine THP levels in class Ⅲ or Ⅳ heart failure were lower than those in normals. Serum and urine THP levels decreased in parallel with the severity of heart failure.After cardiac functions were improved Ⅱ or more classes, serum β_2M levels decreased and Cβ_2M increased markedly, serum and urine THP levels also increased significantly in 14 patients with heart failure.The results of this study suggests that functional impairment of the kidneys not only located in the glomeruli, but also in the proximal and distal tubules in patients with congestive heart failure. Serum and urine β_2M and THP may be sensitive markers to locate the site and identify the severity of renal dysfunction in patients with congestive heart failure.
出处
《中国循环杂志》
CSCD
1994年第2期83-85,共3页
Chinese Circulation Journal
关键词
心力衰竭
Β2微球蛋白
Congestive heart failure
Beta_2-microglobulin
Tamm-Horsfall protein
