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1、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(acutekidneyinjury，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(endstagerenaldisease,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AK
2、I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±11.5pg/mL、63.5±15.7pg/mL、14.8±3.2pg/mL、15.9±3.5pg/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
3、.1pg/mL、7.2±1.2pg/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；Thesi
4、gnificanceofTNF-aandIL-6intheearlydiagnosisofacutekidneyinjuryHuangDeng-peng,DepartmentofNephrology,Lianzhoupeople,sHospital,Guangdong513400,ChinaCorrespondingauthor:HuangDeng-peng,Email:lzhuang009@yahoo.com.cn【Abstract】ObjectivesToinvestigatethesigni
5、ficanceofTNF-aandIL-6changesinurineinpatientswithacutekidneyinjury(AKI).MethodsClinicalpresentations,andurineandserumsampleswerecollectedinpatientsadmittedtoourhospitalinJanuarytoOctober2009withslightAKI(50cases),medium-severeAKI(50cases),andcriticali
6、llnesspatients(30cases),endstagerenaldisease(ESRD,60cases)basedontheRIFLEcriteria.Urineandserumsampleswerealsocollectedfrom60healthycontrols.UrinaryTNF-aandIL-6wasassayedbyELISA,ThecorrelationbetweenTNF-aandIL-6inurinewasanalyzed,andthesensitivityands
7、pecificityofurinaryTNF-aandIL-6intheearlydiagnosisofAKIwereevaluated.ResultsurinaryTNF-aofslightAKI,medium-severeAKI,ESRD,criticalillnesspatientsandnormalcontrolsare36.5±11.5pg/mL,63.5±15.7pg/mL,14.8±3.2pg/mL,15.9±3.5pg/mLand15.3±3.6.UrinaryIL-6are15.
8、2±4.8pg/mL,18.6±6.2pg/mL,6.8±1.1pg/mL,7.2±1.2pg/mLand6.4±0.8pg/mL.UrinaryTNF-aandIL-6increasedsignificantlyinpatientswithslightandmedium-severeAKI,ascomparedwiththatinESRDpatientsandnormalcontrols(P＜0.05).UrinaryTNF-aandIL-6washigherinpatients
