ADA、Lp(a)联合hs-CRP检测在儿童原发性肾病综合征诊断中的价值探讨李清红吕海光(泰山医学院附属医院检验科山东泰安271000)【摘要】目的:探讨血清腺苷脱氨酶(ADA)、脂蛋白a[Lp(a)】和超敏C反应蛋白(hs-CRP>检测在儿童原发性肾病综合征(PNS)病变屮的临床应用价值。方法：在曰立7600全&动生化分析仪上检测31例单纯型NS患儿(单纯型NS组)、29例肾炎型NS患儿(肾炎型NS组)和65例健康体检者(对照组)血淸标本屮的白蛋白(ALB)、ADA、Lp(a)、hs-CRP、肌酐(Crea)和尿素(Urea),用SPSS统计学软件对检出结果进行统计学分析。结果：疾病组血清ADA、Lp(a)、hs-CRP、Crea和Urea水平明显高于对照组，组间比较差异有统计学意义(P<0.05);血清ALB水平低于对照组，组间比较差异有统计学意义(P<0.05)。ADA、Lp⑻和hs-CRP与ALB分别呈显著负相关，与Crea和Urea分别呈显著正相关。ADA、Lp(a)和hs-CR三项指标联检在单纯型NS组和肾炎型NS组的阳性检出率(87.10%,89.66%)明显高于三项单独在各组的阳性检出率(45.16%,61.29%，67.74%;72.14%,62.07%,75.86%),各组比较差异有高度统计学意义(P<0.05)。结论：ADA、Lp(a)、hs-CRP可作为儿童PNS诊断的常规生化指标，联合检测可提高疾病的阳性检出率，其浓度水平变化对疾病诊断、病情监测和判断具有较高的临床参考价值。【关键词】原发性肾病综合征；超敏C反应蛋白；腺苷脱氨酶；XC6001【中图分类号】R44【文献标识码】A【文章编号】1007-8231(2015)16-0097-03ValueofADA,Lp(a)combinedwithhs-CRPdetectionindiagnosisofprimarynephroticsyndromeinchildrenLiQinghong,LvHaiguang.TheClinicalLaboratoryoftheAffiliatedHospitalofTaishanMedicalUniversity,Shandong,China,271000.【Abstract】ObjectiveToinvestigatetheclinicalsignificanceofserumadenosinedeaminase(ADA)andlipoproteina[Lp(a)]andhighsensitiveCreactiveprotein(hsCRP)testinchildrenwithprimarynephroticsyndrome(PNS)lesionsinclinicalapplicationvalue.Methods:OntheHitachi7600automaticbiochemicalanalyzertestingof31casesofsimpletypeinchildrenwithNS(simpletypeNSgroup)and29casesofnephritisinchildrenwithNS(nephritictypeNSgroup)and65casesofhealthyperson(controlgroup)intheserumofalbumin(ALB),ADA,LP(a),hsCRP,serumcreatinine(Crea)andurea(Urea),usingSPSSstatisticalsoftwareforthetestingresultswerestatisticallyanalyzed.ResultsDiseasegroup,theserumADA,LP(a),hs-CRP,CreaandUrealevelswassignificantlyhigherthanthatofthecontrolgroup,thedifferencebetweenthetwogroupshasstatisticalsignificance(P<0.05);serumALBlevelslowerthanthecontrolgroup,thedifferencebetweenthetwogroupshasstatisticalsignificance(P<0.05J.ADA,LP(a)andhs-CRPandALBweresignificantlynegativecorrelation,andCreaandUreaweresignificantlyandpositivelyrelated.ADA,LP(a)andhs-CRPthreeindexesinspectioninsimpleNSgroupandnephritisNSgroup,thepositiverate(87.10%,89.66%)Significantlyhigherthanthreeineachgroupofthepositivetestingrate(45.16%,61.29%,67.74%;62.07%,72.14%,75.86%),thedifferencewashighlystatisticallysignificant(P<0.05).ConclusionADA,Lp(a),hs-CRPcanbeusedasaroutinebiochemicalindicatorfordiagnosisofPNSinchildren,andjointtestingcanimprovediseasepositiverate,itsconcentrationlevelchangefordiseasediagnosis,diseasemonitoringandjudgmenthashigherclinicalvalue.【Keywords]PrimaryNephroticsyndrome;HighSensitivityCReactiveProtein;Adenosinedeaminase;Lipoproteina原发性肾病综合征(PrimaryNephroticsyndrome,PNS)是最常见的儿童肾脏疾病之一，由多种病因引起的一组以肾小球基膜通透性增加、伴肾小球滤过率降低等肾小球病变为主的自身免疫系统性抑制性疾病。患病多见于3〜6岁的幼儿，男孩多于女孩。其病因和发病机制尚不清楚，诱因不明确，多隐匿起病，发病率较高，逐年呈上升趋势。早期不易发现，个别患儿就诊吋往往己发展为终末期肾病，严重影响...