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目的探讨尿微量蛋白检测在肺炎支原体(MP)感染患儿肾脏损伤中的诊断意义,以便发现早期肾脏损害,积极进行预防和治疗。方法随机选择儿科2010年3月至2013年11月收治的部分肺炎患儿共96例,其中支原体感染患儿40例,其他病原体(除外溶血性链球菌等易引起肾脏损伤的病原体)感染的患儿56例。检测尿微量白蛋白(MA)及尿β2-微球蛋白(β2-MG)的含量。同时做尿常规、血肌酐、尿素氮及其他常规检查。比较两组患儿之间MA、尿β2-MG水平及其与尿常规蛋白定性的异常检出率。结果与其他感染组患儿比较,MP感染患儿MA、尿β2-MG的水平明显增高(P均<0.01)。MP感染患儿MA的异常检出率为35.0%,而尿β2-MG的异常检出率为12.5%,两者比较差异有统计学意义(P<0.05)。在14例MA阳性的MP感染组患儿中,只有4例尿常规蛋白定性异常,提示即使尿常规蛋白定性阴性,也可能已经出现早期肾脏损害。治疗前MP感染患儿MA的异常检出率为35.0%,经积极抗感染治疗后MA的异常检出率为7.5%,差异有统计学意义(P<0.01)。结论 MA检测可作为MP感染患儿早期肾脏损害较为敏感的诊断指标之一;MP感染肾脏损害以肾小球受累为主,也可能累及肾小管。
Objective To investigate the diagnostic value of urinary microalbuminuria in renal injury in children with Mycoplasma pneumoniae (MP) infection so as to detect early renal damage and actively prevent and treat it. Methods A total of 96 children with pneumonia were selected from March 2010 to November 2013 in our hospital. Among them, 40 were infected with mycoplasma and 40 were infected with other pathogens (except those susceptible to kidney damage such as hemolytic streptococcus) 56 cases of children. Urine microalbuminuria (MA) and urinary β2-microglobulin (β2-MG) content were measured. Urine routine at the same time, serum creatinine, urea nitrogen and other routine tests. The MA and urinary β2-MG levels were compared between the two groups of children and the prevalence of abnormalities of urine protein and urine routine protein was analyzed. Results Compared with other infected children, the levels of MA and urinary β2-MG in children with MP infection were significantly increased (all P <0.01). The prevalence of MA in children with MP infection was 35.0%, while that of urine β2-MG was 12.5%. There was significant difference between the two (P <0.05). Of the 14 MA-positive MP-infected children, only 4 showed abnormalities in urinary routine protein, suggesting that early kidney damage may have occurred even though urinary routine protein is qualitatively negative. The detection rate of MA in children with MP infection before treatment was 35.0%, and the detection rate of MA after active anti-infection therapy was 7.5%, the difference was statistically significant (P <0.01). Conclusions MA assay can be used as a sensitive indicator of early renal damage in children with MP infection. MP-induced renal damage mainly involves glomerular involvement, which may also affect the renal tubules.