血清视黄醇结合蛋白在肾脏疾病中的应用

目的　探讨血清视黄醇结合蛋白 (sRBP)在肾脏疾病中的应用价值。方法　测定sRBP、尿RBP(uRBP)、尿素 (Urea)、肌酐 (Cr)、尿酸 (UA)、尿IgG、转铁蛋白 (Trf)、微量白蛋白 (mAlb)、α1 微球蛋白 (α1 MG)以及血 β2 微球蛋白 (sβ2 MG)和尿 β2 微球蛋白 (uβ2 MG) ,并进行相关的统计学分析。结果　 ( 1) 81例肾病患者sRBP的结果为 ( 87.83± 32 .74 )mg/L ,对照组为 ( 5 6 .17± 14 .34)mg/L ,肾病组明显高于对照组 (P <0 .0 0 1) ;( 2 )比较常规肾功能检测项目 ,肾病患者sRBP阳性率与Urea较接近 ,但明显高于Cr ;( 3)sRBP与sβ2 MG显著相关 (P <0 .0 1) ,慢性肾小球肾炎组sRBP与各项肾功能指标相关性最好 ;( 4 )与正常组比较 ,糖尿病无肾病组、慢性肾盂肾炎组uRBP(P <0 .0 1～P <0 .0 0 5 )升高较sRBP(P <0 .0 5 )显著 ,糖尿病肾病组、慢性肾小球肾炎组sRBP(P <0 .0 0 1)升高较uRBP(P <0 .0 1～P <0 .0 0 5 )显著。结论　sRBP可以作为反映肾功能异常的较敏感指标。血、尿RBP同时检测较 β2 MG更稳定 ,可作为评价肾病患者肾功能受损程度及部位的指标     

470例小儿肾脏疾病尿视黄醇结合蛋白测定

目的 探讨各型肾脏疾病患儿肾小管受累情况以及建立小儿尿视黄醇结合蛋白（RBP）正常值。方法 应用酶联免疫吸附试验（ELISA测定各型肾脏疾病小儿尿RBP的含理。结果 以单侧95%百分位数确定尿RBP小儿正常对照组的上限值为13.45μg/mmolCr;各病组阳性百分值（大于正常组95%百分位数的例数与该组总病例数之比）以急性肾衰,慢性肾衰和糖尿病（100%）3组最高;其他依次为肝豆状核变性（88.89%) ,乙型肝炎相关性肾炎（78.57%),狼疮性肾炎（76.92%),肾病综合征（64.08%),病毒性肾炎（60.00%)、IgA肾炎（58.82%),过敏性紫瘢肾炎（47.19%),遗传性肾炎（33.33%),急性肾小球肾炎（28.00%)和肾炎综合征（22.64%)组;以单纯性血尿组（15.00%)最低。结论 尿RBP含量升高提示患儿肾脏受损部位为肾小管;各型肾脏疾病尿RBP测定值大小显示肾小管受损程度。     

470例小儿肾脏疾病尿视黄醇结合蛋白测定

目的探讨各型肾脏疾病患儿肾小管受累情况以及建立小儿尿视黄醇结合蛋白(RBP)正常值.方法应用酶联免疫吸附试验(ELISA,测定各型肾脏疾病小儿尿RBP的含量.结果以单侧95%百分位数确定尿RBP小儿正常对照组的上限值为13.45 μg/mmol Cr;各病组阳性百分值(大于正常组95%百分位数的例数与该组总病例数之比)以急性肾衰、慢性肾衰和糖尿病(100%)3组最高;其他依次为肝豆状核变性(88.89%)、乙型肝炎相关性肾炎(78.57%)、狼疮性肾炎(76.92%)、肾病综合征(64.08%)、病毒性肾炎(60.00%)、IgA肾炎(58.82%)、过敏性紫瘢肾炎(47.19%)、遗传性肾炎(33.33%)、急性肾小球肾炎(28.00%)和肾炎综合征(22.64%)组;以单纯性血尿组(15.00%)最低.结论尿RBP含量升高提示患儿肾脏受损部位为肾小管;各型肾脏疾病尿RBP测定值大小显示肾小管受损程度.     

乙型肝炎患者视黄醇结合蛋白和β2-微球蛋白的检测意义

近年来,乙型肝炎的发病率一直处于上升的趋势。大量研究表明恶性肿瘤、结缔组织病人血清发现β2-微球蛋白(β2-MG)浓度升高,各种类型的肝脏病人β2-MG增高的阳性率为     

血清视黄醇结合蛋白测定在2型糖尿病肾病中的临床意义

目的探讨血清视黄醇结合蛋白（RBP）在2型糖尿病肾病（DN）中的临床意义。方法采用免疫透射比浊法测定100例2型糖尿病（DM）（包括单纯DM48例、DN52例）和60名健康体检者血清RBP浓度,同时测定血清尿素（Urea）水平。结果单纯DM及DN患者血清RBP浓度明显高于对照组（P〈0．05、P〈0．01）。DN患者随着病情进展,RBP浓度逐渐升高。结论血清RBP是一个早期、敏感的肾功能指标,与DN疾病严重程度平行,可作为早期诊断DN较为理想的指标。     

肝炎患者血清视黄醇结合蛋白（RBP）测定临床意义

视黄醇结合蛋白(Retnol Binding Protein,RBP)是由单一肽链和小部分碳水化合物组成。RBP主要由肝细胞合成，广泛分布于人体血清、脑脊液和尿液等体液中。肝脏炎症时，由于肝功能受损，从而引起RBP的生成障碍。本文旨在探讨不同类型肝炎患者血清中RBP的不同变化。     

血清视黄醇结合蛋白测定在2型糖尿病肾病中的临床意义

目的探讨血清视黄醇结合蛋白(RBP)在2型糖尿病肾病(DN)中的临床意义。方法采用免疫透射比浊法测定100例2型糖尿病(DM)(包括单纯DM 48例、DN 52例)和60名健康体检者血清RBP浓度,同时测定血清尿素(Urea)水平。结果单纯DM及DN患者血清RBP浓度明显高于对照组(P<0.05、P<0.01)。DN患者随着病情进展,RBP浓度逐渐升高。结论血清RBP是一个早期、敏感的肾功能指标,与DN疾病严重程度平行,可作为早期诊断DN较为理想的指标。     

探讨血清视黄醇结合蛋白和胱抑素C在肾脏疾病中的诊断价值

目的：探讨血清视黄醇结合蛋白（retinol blinding protein ,RBP）和胱抑素C（Cystatin C ,CysC）联合检测在肾脏疾病中的临床诊断价值。方法采用Beckman‐Coulter全自动生化仪分别检测173例肾病患者和50例健康体检者的血清尿素氮（U‐rea）、肌酐（Cr）、尿酸（UA）、视黄醇结合蛋白（RBP）、胱抑素C（CysC）的含量,并进行相关的统计学分析。结果173例肾病患者的RBP浓度为（70．86±14．41）mg／L ,CysC浓度为（3．41 ± 0．65）mg／L ,对照组RBP浓度为（41．36±5．68）mg／L ,CysC浓度为（0．98 ± 0．20）mg／L ,肾病组明显高于对照组（P＜0．05）。各疾病组 Cysc的检出阳性率最高,RBP次之,二者联合检测阳性率更高,明显高于传统肾功能指标Urea、Cr、UA。结论血清视黄醇结合蛋白和胱抑素C可作为诊断肾脏疾病的敏感指标,二者联合检测可提高诊断阳性率。     

血清视黄醇结合蛋白在肾病早期诊断中的应用

目的探讨血清视黄醇结合蛋白(RBP)在高血压肾病早期诊断中的应用价值。方法采用免疫透射比浊法和速率法检测65例肾病患者血清RBP、尿素(Urea)、肌酐(Cr),同时检测53例健康体检者作为对照。结果与对照组相比,肾病患者各组血清中RBP、Urea、Cr含量均有不同程度升高,其中RBP含量升高最为显著。结论血清RBP水平反映肾小球的滤过功能,可以作为肾病早期诊断的较敏感指标。     

糖化血红蛋白胱抑素C及视黄醇结合蛋白在糖尿病肾病早期诊断中的表达

目的探讨血清胱抑素C(Cys C)、视黄醇结合蛋白(RBP)及糖化血红蛋白(HbA1c)联合检测对糖尿病肾病早期诊断的诊断价值。方法同时检测106例单纯糖尿病患者(DM组)、95例糖尿病肾病患者(DN组)和108例健康者(健康对照组)血清Cys C、RBP及HbA1c,按照HbA1c的含量分成高、中、低组,并进行相关统计学分析。结果 DM组HbA1c(高值为10.80%±1.80%)与健康对照组(4.70%±0.98%)比较,差异有统计学意义(P<0.01),Cys C、RBP差异无统计学意义(P>0.05);DN组HbA1c高值组HbA1c12.8%±1.8%、Cys C(1.52±0.28)mg/L、RBP(180.4±81)mg/L与健康对照组HbA1c4.70%±0.98%、Cys C(0.58±0.15)mg/L、RBP(42.30±8.63)mg/L比较,差异均有统计学意义(P<0.01)。结论 HbA1c、RBP及Cys C在糖尿病肾病早期诊断中的表达是非常敏感和特异的。     

视黄醇结合蛋白在糖尿病早期肾损害的监测

目的 探讨视黄醇结合蛋白(RBP)在糖尿病早期肾损害诊断中的意义.方法 采用免疫速率散射比浊法和免疫透射比浊法,检测75例2型糖尿病患者及60例正常人尿(血)视黄醇结合蛋白(RBP),尿微量清蛋白(mAlb),尿β2-微球蛋白(β2-MG),和尿转铁蛋白(Trf)的变化.同时,用酶法检测其血清尿素(Urea),血肌酐(Cr)的变化.结果 2型糖尿病患者的尿RBP、mAlb、β2-MG、Trf结果均明显高于对照组,差异有显著性(P<0.01),血RBP也明显高于对照组,差异有显著性(P<0.05).结论 糖尿病早期会出现肾小管功能损害,RBP可作为诊断肾病早期损害的敏感性指标.同时检测尿、血RBP有助于提高阳性率,且尿RBP的敏感性优于血RBP.     

免疫比浊法测定血清视黄醇结合蛋白方法学评价

目的对免疫透射比浊法测定血清视黄醇结合蛋白(RBP)进行方法学评价。方法采用免疫比浊测定法,根据美国临床实验室标准化委员会(NCCLS)相关文件,对该方法进行精密度、线性、准确性等评价及临床初步应用。结果批内CV%4.0%,批间CV%5.0%。抗干扰性强,Hb≤4.0g/L、胆红素小于或等于420μmol/L、三酰甘油小于或等于10mmol/L对测定无影响;与进口试剂对比,Y=1.0075X+0.0029,r=0.9995,两者相关性良好,试剂开瓶稳定性良好。结论免疫比浊测定血清视黄醇结合蛋白,方法简便、快速、灵敏,结果准确,可用自动分析仪测试,适合临床检验科应用。     

Immunonephelometric determination of retinol-binding protein in serum and urine

An immunonephelometric method developed for measurement of retinol-binding protein (RBP) in serum and urine can detect it in concentrations of about 30 micrograms/L, which is in the lower limit of its normal concentration in urine (range 0-0.56 mg/L; mean +/- SD 0.19 +/- 0.15; n = 44). Urinary RBP was increased (range 0.93-29.5 mg/L) in all of 25 urine specimens from 13 subjects being treated with aminoglycoside (tobramycin). Urinary excretion of RBP was correlated (r = 0.83) with the excretion of beta 2-microglobulin. The within-assay and day-to-day precision (CV) was determined over the detection range of 0.03-8 mg/L. Within these limits the corresponding CVs varied from 4 to 27% and from 8 to 30%, respectively. The method had fairly good precision within the optimal measuring range of approximately 0.4 to 4.5 mg/L for both urine and 20-fold diluted serum samples. For various RBP concentrations our analytical recovery was 89-114% of added RBP. Results by this method correlated well (r = 0.96, n = 24) with those by a radial immunodiffusion method.     

A radioimmunoassay for retinol-binding protein in serum and urine

In this radioimmunoassay for human retinol-binding protein (RBP), sample (serum, diluted as much as 3600-fold; or urine, diluted or undiluted) or calibrant (purified RBP in phosphate buffer containing bovine serum albumin) is incubated with 125I-labeled RBP and rabbit anti-human RBP antiserum for 24 h before separation with second antibody/polyethylene glycol. The assay's sensitivity is 5 micrograms/L, its useful working range 10 to 200 micrograms/L. The between-batch CV is 12.5% at 12 micrograms/L, 7% at 120 micrograms/L. Results correlate well (r = 0.99) with those by radial immunodiffusion. The reference interval for RBP in serum of men is 39-75 mg/L (mean 57), significantly (p less than 0.01) broader than for women (29-66 mg/L; mean 48). The 2.5-97.5 centile interval for RBP in urine is from less than 0.5 to 12.2 micrograms per millimole of creatinine (median 5.8). RBP in urine is unstable below pH 5.0 at 37 degrees C.     

Enzyme-linked immunosorbent assay of retinol-binding protein in serum and urine

This highly sensitive method for determining retinol-binding protein in human serum and urine is based on a double-antibody "sandwich"-type enzyme-linked immunosorbent assay. The assayable concentration range is 0.8-48 micrograms/L, the detection limit 0.2 micrograms/L. Within-assay coefficients of variation for 10 determinations at two different concentrations were 5.5 and 5.8%. The corresponding between-assay CVs were 7.9 and 9.2%. We saw no interference from any components of urine or serum. The mean urinary excretion by 30 healthy subjects, as determined by this method, was 101 micrograms/g of creatinine (SD 38.8). The concentration in serum averaged 43 mg/L (SD 12.1).     

Kinetic nephelometric determination of transthyretin and retinol-binding protein in neonatal serum

We have developed a kinetic immunonephelometric method for the determination of retinol-binding protein and modified the method of Jacob et al (Clin Chem 1983; 29: 564) for the determination of transthyretin (prealbumin) in neonatal serum specimens from small, premature infants. The methodologies allow detection of 17.5 mg/l transthyretin and 1.7 mg/l retinol-binding protein in 25 microliter of serum. Between-run precision studies using pooled neonatal serum gave CV values of 3% and 5-6% for transthyretin and retinol-binding protein, respectively. Results obtained for neonatal specimens using this method agreed well with those obtained for the same specimens using radial immunodiffusion. Mean (SD) serum concentrations for 39 neonatal specimens were 100.4 (46.6) and 26.3 (10.8) mg/l for transthyretin and retinol-binding protein, respectively.