尿TNFa与IL6在急性肾损伤早期诊断中的价值.docVIP

尿TNF-a与IL-6在急性肾损伤早期诊断中的价值 广东省连州市人民医院（513400） 黄登鹏 【摘要】目的 观察肿瘤坏死因子（TNF-a）与白细胞介素-6（IL-6）在急性肾损伤(acute kidneyinjury，AKI)患者尿液中的变化，探讨其在AKI 早期诊断中的意义。方法 收集2009年1月至2011年2月我院肾内科及ICU住院的AKI患者、终末期肾脏病(end stage renal disease,ESRD)患者及健康对照者的血清、尿液及临床表现等资料。按照RIFLE标准，将住院治疗患者分为轻度AKI组50例、中重度AKI组50例；另外，危重病组30例、ESRD组60例和健康对照组60例；采用ELISA方法检测尿TNF-a与IL-6，评价尿TNF-a与IL-6在AKI早期临床诊断中的价值和意义。结果 轻度AKI组、中重度AKI组、ESRD组、危重病组和健康对照组的尿TNF-a分别是36.5±11.5 pg/mL、63.5±15.7 pg/mL、14. 8±3.2 pg/mL、15. 9±3.5 pg/mL和15. 3±3.6；尿IL-6分别是15. 2±4.8pg/mL、18. 6±6.2pg/mL、6. 8±1.1pg/mL、7. 2±1.2 pg/mL、6.4±0.8pg/mL。与健康对照组及ESRD组和危重病组比较，轻度AKI组和中重度AKI组，尿TNF-a与IL-6均有明显升高(P＜0.05)；其中中、重度AKI组较轻度AKI组尿TNF-a与IL-6升高更明显(P＜0.05)；危重病组、ESRD组尿TNF-a与IL-6与健康对照组比较差异无统计学意义（P＞0.05）。结论 AKI发生时，检测尿中TNF-a与IL-6有助于AKI的早期临床诊断。 【关键词】肿瘤坏死因子；白细胞介素-6；急性肾损伤； The significance of TNF-a and IL-6 in the early diagnosis of acute kidney injury Huang Deng-peng, Department of Nephrology, Lianzhou people,s Hospital, Guangdong 513400, China Corresponding author: Huang Deng-peng, Email: lzhuang009@ 【Abstract 】Objectives Toinvestigate the significance of TNF-a and IL-6 changes in urine in patients with acute kidney injury(AKI).Methods Clinical presentations, andurine andserum samples were collected in patients admitted to our hospital in Januaryto October 2009 with slightAKI (50 cases), medium-severe AKI (50 cases), and critical illness patients(30 cases),endstage renaldisease (ESRD,60cases) basedon the RIFLE criteria. Urine and serum samples were also collected from 60 healthy controls. Urinary TNF-a and IL-6 was assayed by ELISA, The correlation between TNF-a and IL-6 in urine was analyzed, and the sensitivity and specificityof urinary TNF-a and IL-6 in the earlydiagnosis of AKI were evaluated.Results urinary TNF-a of slightAKI, medium-severe AKI, ESRD, critical illness patients and normalcontrols are 36.5?11.5 pg/mL,63.5?15.7 pg/mL,14. 8?m.2 pg/mL,15. 9?m.5 pg/mL and 15. 3?n.6. Urinary IL-6 are 15. 2? .8pg/mL,18. 6?L.2pg/mL,6. 8?L.1 pg/mL,7. 2?L.2 pg/mL