目的　探讨肾早期损伤指标α1微球蛋白与微量白蛋白比值，对特发性急性间质性肾炎（AIN）的诊断价值。 方法　回顾2014年1月至2017年12月收治的12例AIN患儿的肾早期损伤指标、尿蛋白电泳结果，分析尿α1微球蛋白与 微量白蛋白比值，及其与尿蛋白电泳中小分子蛋白百分比的相关性。采用同期住院初发初治的Dent病、肾病综合征、IgA 肾病、紫癜性肾炎、狼疮性肾炎和Alport综合征患儿各10例作为对照组。结果　与Dent病对照组一致，12例AIN患儿的 肾早期损伤指标均以α1微球蛋白升高为主，尿α1微球蛋白与微量白蛋白比值均>1，且与尿蛋白电泳中小分子蛋白百 分比呈正相关（P<0.05），而其他肾小球疾病对照组的肾早期损伤指标均以微量白蛋白升高为主，尿α1微球蛋白与微量 白蛋白比值均接近零。结论　尿α1微球蛋白与微量白蛋白比值>1可作为小分子蛋白尿的一个判断指标，用于临床AIN 等肾小管间质性疾病的定位诊断。

Objective　To explore the diagnostic value of the ratio of α1-microglobulin to microalbumin in acute interstitial nephritis. Methods　Data were collected from 12 childhood acute interstitial nephritis patients from Jan. 1, 2014 to Dec. 31, 2017. The ratio of α1-microglobulin to microalbumin, and urine protein electrophoresis were monitored and analyzed. Each 10 cases of Dent disease, nephrotic syndrome, IgA nephropathy, Henoch-Sch?nlein purpura nephritis, lupus nephritis and Alport syndrome were included at the same duration as control group. Results　In all the 12 cases, α1-microglobulin was increased apparently, the ratio of α1-microglobulin to microalbumin was much higher than 1, and was closely related to the percentage of low molecular weight protein in urine protein electrophoresis (P<0.05), the same as Dent disease, while the ratio was about zero in other glomerular disease groups. Conclusions　The ratio of α1-microglobulin to microalbumin, if over 1, can be used as a diagnostic criteria for tubuloproteinuria.