尿ET-1检测在小儿肾盂输尿管连接部梗阻诊断及随访中的意义

发布时间：2018-02-26 22:22

  本文关键词： 内皮素-1 肾盂输尿管连接部梗阻 肾积水　出处：《广州医学院》2012年硕士论文　论文类型：学位论文

【摘要】：目的 探讨尿液内皮素-1（endothelin-1，ET-1）在肾盂输尿管连接部梗阻（ureteropelvicjunction obstruction，UPJO）肾积水患儿诊断及术后随访中的作用及其意义。 方法 本研究随机选取30例在广州市妇女儿童医疗中心小儿泌尿外科就诊、确诊为单侧UPJO并行肾盂输尿管成形术的患儿；30例对照组儿童，其中包括10例健康儿童，10例膀胱输尿管返流（vesicoureteral reflux，VUR）的患儿和10例肾结石的患儿。研究组患儿，分别在术前留取尿液标本、术中从肾盂抽取尿液标本，并在术后1、3、6、9、12月分别留取尿液标本。对照组儿童也同样留取尿液标本。所有尿液标本，均用酶联免疫吸附法（ELISA法）检测尿液ET-1值，同时测定尿肌酐（Cr）。 结果 研究组中，术前尿ET-1水平显著高于其他三个对照组，差异有统计学意义（P＜0.05）。在患儿术后随访中，尿ET-1值在行肾盂输尿管成形术1年后显著下降。在整个研究组样本中，以ET-13fmol/mg Cr为诊断界值，敏感性为76.7%，特异性为90%，总准确率为83.3%。在8个婴儿（≤1岁）的样本中，以5fmol/mg Cr为诊断界值，则敏感性和特异性均为100%。 结论 尿液ET-1作为一个有效的生物学标志物，具有敏感、特异、方便、非侵入性等优点，在小儿UPJO的尿生物学诊断及长期随访中具有较好的应用前景。
[Abstract]:Purpose. To investigate the role and significance of urine endothelin-1 endothelin-1 (et 1) in the diagnosis and postoperative follow-up of hydronephrosis in children with ureteropelvic junction obstruction. Method. This study randomly selected 30 children who were diagnosed as unilateral UPJO combined with pyeloureteroplasty in Guangzhou Women and Children Medical Center for urology, 30 children in the control group. The study group included 10 healthy children with vesicoureteral reflux VURs and 10 patients with renal calculi. Urine samples were taken from the renal pelvis before operation in the study group, and urine samples were taken from the renal pelvis during the operation in the study group. Urine samples were collected on December. Urine samples were also collected from children in the control group. All urine samples were detected by Elisa and urine creatinine (creatinine) was measured by enzyme-linked immunosorbent assay (Elisa). Results. In the study group, the preoperative urinary ET-1 level was significantly higher than that in the other three control groups (P < 0.05). During the follow-up, the urinary ET-1 value decreased significantly after pyeloplasty for one year. The sensitivity of ET-13fmol/mg Cr was 76. 7 and the specificity was 90. The total accuracy was 83. 3%. In the samples of 8 infants (鈮，

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