血清α1-微球蛋白、β2-微球蛋白对肾积水患儿肾盂输尿管形成术后患侧分肾功能降低的预测价值OA

Objective To explore the predictive value of preoperative serum α1-microglobulin(α1-MG)andβ2-microglobulin(β2-MG)for the reduction of the contralateral renal function(DRF)in children with hydro-nephrosis after pyeloureteral formation surgery.Methods A total of 108 children with hydronephrosis admit-ted to Beijing United Family Jingbei Women and Children's Hospital from July 2022 to January 2025 were se-lected as the research subjects.All children received pyeloureteral formation surgery treatment.According to the results of renal radionuclide imaging scans 3 months after surgery,the children were divided into the DRF reduction group and the normal DRF group.Clinical data of the children were collected,and the levels of ser-um α1-MG and β2-MG were compared between the two groups.Multivariate Logistic regression analysis was used to analyze the influencing factors of DRF reduction on the contralateral side after pyeloureteral formation surgery in children with hydronephrosis.The receiver operating characteristic(ROC)curve was drawn to ana-lyze the predictive value of serum α1-MG and β2-MG for the DRF reduction on the contralateral side after pye-loureteral formation surgery in children with hydronephrosis.Results The preoperative cross-sectional diame-ter ratio of kidneys in the DRF reduction group was smaller than that in the normal DRF group(P＜0.05),and the preoperative DRF on the affected side was lower than that in the normal DRF group(P＜0.05).The levels of serum α1-MG and β2-MG were higher than those in the normal DRF group,and the differences were statistically significant(P＜0.05).The results of multivariate Logistic regression analysis showed that elevat-ed levels of serum α1-MG and β2-MG were risk factors for the reduction of the DRF on the contralateral side after pyeloureteral formation surgery in children with hydronephrosis(P＜0.05),while increased transverse diameter ratio of the kidneys and elevated DRF on the contralateral side before surgery were protective factors for the reduction of the DRF on the contralateral side after pyeloureteral formation surgery in children with hydronephrosis(P＜0.05).The results of ROC curve analysis showed that the area under the curve(AUC)of the combined prediction of the two indicators for DRF reduction on the contralateral side after pyeloureteral formation surgery in children with hydronephrosis was 0.945,which was greater than the AUC of serum α1-MG and β2-MG alone(Z=4.52,3.87,both P＜0.05).Conclusion The levels of serum α1-MG and β2-MG are closely related to the DRF reduction on the affected side after pyeloureteral formation surgery in children with hydronephrosis,and both are influencing factors for the reduction of postoperative DRF on the contralateral side.The combined detection of these two indicators has a high predictive value for the reduction of DRF on the affected side after pyeloureteral formation surgery in children with hydronephrosis.