尿中的β2-微球蛋白对于诊断急性焦点细菌性炎的有用性
Kisho Shimura1, Ryosuke Fukushima2, Takuma Sakon2
1Fujisawa City Hospital, Fujisawa, Kanagawa, Japan. shimura-k@outlook.com.
European journal of pediatrics
|April 2, 2025
概括
尿中的β2-微球蛋白 (U-β2MG) 水平可以帮助在患上尿路感染的儿童中区分急性焦点细菌性炎 (AFBN) 和急性炎 (APN). 结合U-β2MG和C-反应蛋白 (CRP) 测量,可以在没有侵入性成像的情况下改善AFBN诊断.
科学领域:
- 儿科脏病学 儿科脏病学
- 传染性疾病 传染性疾病
- 生物标志物研究 生物标志物研究
背景情况:
- 尿路感染 (UTI) 在儿童中很常见,上部尿路感染需要准确的诊断.
- 区分急性焦点细菌性炎 (AFBN) 和急性炎 (APN) 对于适当的治疗至关重要.
- 尿中的β2-微球蛋白 (U-β2MG) 是管损伤的已知标志物,可以帮助区分上部和下部尿路感染.
研究的目的:
- 评估尿中β2-微球蛋白对尿中的肌素进行校正 (U-β2MG/Ucre) 的诊断实用性,以区分儿科患者的AFBN与APN.
- 确定U-β2MG/Ucre和C反应蛋白 (CRP) 的最佳值,用于诊断AFBN.
主要方法:
- 对患有上部尿路感染的儿科患者 (16岁以下) 的回顾性研究,分为AFBN和APN组.
- 两组之间的U-β2MG/Ucre水平的比较.
- 多重回归分析和接收器操作特征 (ROC) 曲线分析,以确定U-β2MG/Ucre和CRP的诊断值.
主要成果:
- 与APN组 (1525μg/gCr) 相比,AFBN组 (10762μg/gCr) 的U-β2MG/Ucre水平显著更高 (P=0.007).与APN组 (1525μg/gCr) 相比,AFBN组 (10762μg/gCr) 的U-β2MG/Ucre水平显著更高 (P=0.007).
- 在AFBN患者 (P=0.004) 中,多重回归证实了更高的Log(U-β2MG/Ucre).
- 最佳的值是U-β2MG/Ucre在2070μg/gCr和CRP在5.7 mg/dL,在一起使用时达到95%的灵敏度和68%的特异性.
结论:
- 与APN相比,儿科AFBN中的U-β2MG/Ucre水平显著升高.
- U-β2MG/Ucre作为一种有价值的生物标志物,可以在上部尿路感染中区分AFBN和APN.
- 对U-β2MG/Ucre和CRP的综合评估可以提高AFBN诊断,可能减少对侵入性成像的需求.
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