中文摘要：

目的：探讨联合检测甲状旁腺素（PTH）、β2-微量球蛋白（β2-MG）及超敏C反应蛋白（hs-CRP）对急性肾功能衰竭（ARF）和慢性肾功能衰竭（CRF）的鉴别诊断价值。方法138例肾功能衰竭（RF）患者分为ARF组64例， CRF组74例。同时选取其他非肾功能衰竭的肾病（NRF）组80例和健康对照组80例，检测并比较4组的PTH、β2-MG及hs-CRP水平，串联分析各组合（PTH＋β2-MG、PTH＋hs-CRP、β2-MG＋hs-CRP及PTH＋β2-MG＋hs-CRP）的诊断效率，选择适合诊断ARF和CRF的最优组合。结果 ARF组的hs-CRP高于CRF和对照组，PTH及β2-MG低于CRF组（P＜0.01），而PTH与对照组差异无统计学意义。CRF组的PTH及β2-MG显著高于对照组,而hs-CRP与对照组无统计学意义。ARF患者hs-CRP及β2-MG多中度＋重度升高（68.7%和81.2%）并伴PTH轻度升高（25.0%）， CRF患者PTH及β2-MG多中度＋重度升高（56.8%和98.6%）并伴hs-CRP轻度＋中度升高（39.2%）。β2-MG及hs-CRP可明显提高ARF的总符合率（TCR）及Youden指数（YI），PTH及β2-MG可明显提高CRF的TCR及YI。结论联合检测PTH、β2-MG及hs-CRP有助于ARF与CRF的鉴别诊断。

英文摘要：

Objective To explore the value of combined detection of parathyroid hormone（PTH）,β2-microglobulin（β2-MG）and high sensitivity C-reactive protein（hs-CRP）in differentiating diagnosis of acute and chronic renal failure. Meth-ods Patients diagnosed with renal failure was divided into acute renal failure patients group （n=64） and chronic renal fail-ure group （n=74） . Other patients with non-renal failure kidney disease （NRF group, n=80） and healthy adult （control group, n=80） were also selected. Levels of PTH,β2-MG, hs-CRP , PTH＋β2-MG, PTH＋hs-CRP,β2-MG＋hs-CRP and PTH＋β2-MG＋ hs-CRP were compared between these four groups to choose the optimal combination for differential diagnosis. Re-sults Hs-CRP in ARF group was significantly higher than that in control group and CRF group. Levels of PTH andβ2-MG were significantly lower in ARF group than that in CRF groups but not in control group （P 〈 0.01）. hs-CRP andβ2-MG in the ARF group were moderately higher （68.7%） and severely higher （81.2%） while PTH was mild higher （25%） in ARF group than those in control group, On the other hand, hs-CRP andβ2-MG in the ARF group were moderately higher （56.8%） and severely higher （98.6%） while PTH was mild higher （39.2%） in ARF group than those in control group. Combina-tion of hs-CRP withβ2-MG could increase total case rate （TCR） and Youden index （YI） of ARF;while combination of PTH andβ2-MG could improve the TCR and YI of CRF. Conclusion Combined detection of PTH,β2-MG and hs-CRP is use-ful in differential diagnosis of ARF and CRF.