尿中微量白蛋白的测定及应用  

Determination of Urinary Microalbumin andIts Clinical Application.

作　　者：魏有仁[1] 侯林浦[1] 王玫[1] 湛玉良[1] 朱立华[1] 

机构地区：[1]中日友好医院,北京医科大学第一医院

出　　处：《生物化学与生物物理进展》1995年第2期169-173,共5页Progress In Biochemistry and Biophysics

摘　　要：应用免疫浊度法在自动分析仪上测定了尿中微量白蛋白。对１４０名健康人一次尿样品测定后求出排出率的参考范围（可信区间９５％），上限为２．８３ｇ／ｍｏｌ肌酐。此法结合尿中Ｎ－乙酰－β－Ｄ－氨基葡萄糖苷酶（ＮＡＧ）测定应用于糖尿病和高血压患者以检测早期肾损伤。结果表明此法能灵敏地检出早期的尿中白蛋白漏出，对肾损伤早期诊断比传统的尿蛋白试验更为可靠。尿中溶酶体酶（如ＮＡＧ）对肾小管损伤是更特异和灵敏的标志物。联合应用尿中微量白蛋白和酶的测定可进一步提高检出率，获得更有价值的信息。同时用血清Ⅳ型胶原测定对糖尿病人作了观察，结果糖尿病人血清Ⅳ型胶原均值也明显高于健康人对照组。这一指征反映了肾单位基底膜胶原蛋白的合成动态。Urinary microalbumin was detectedby an autoanalyzer with the method ofimmunoturbidimetry. The spot urine samplesfrom a group of 140 healthy subjects were de-termined to establish a reference range ofurinary microalbumin excretion rate(confi-dence interval 95%)and its upper limit was2.83 g/mol creatinine. This assay and the uri-nary enzyme(N-acetyl-beta-D-glu-cosaminidase,NAG)determination were ap-plied in the patients with diabetes mellitus andwith hypertension for detecting the incipientnephrological changes. The results showedthat this index was sensitive to detect the ear-ly elevation of albumine excretion in urine andhas been proven to be a more valuable diag-nostic tool in the early diagnosis of renal dam-age than the tradtional urine protein test.Asthe urinary lysosome enzyme(e. g. NAG)ismore specific and sensitive marker of renaltubular injury,it is suggested to combine themicroalbumin and the enzyme assays to yieldmore valuable informations. The serum typeⅣ collagen determination with the enzyme im-munoassay was performed simultaneously inthe same group of patients with diabetes melli-tus. It was found that the mean value ofserum type Ⅳ collagen was higher than that ofthe control group.This index indicated thedynamic process of collagen peptide synthesisoccurred in the basement membrane.

关 键 词：微量白蛋白 尿液检验 白蛋白 临床应用 

分 类 号：R446.122[医药卫生—诊断学]