早期糖尿病肾病相关诊断指标探讨  

Investigation of index of early diabetic nephropathy

作　　者：金秀平[1] 杨春伟[1] 王浩[1] 

机构地区：[1]华北煤炭医学院附属医院内分泌科,河北唐山063000

出　　处：《检验医学与临床》2007年第4期248-250,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨早期糖尿病肾病临床指标中尿微量清蛋白排泄率（UAER）与血清胱氨酸蛋白酶抑制剂C（SCysC）、血清肌酐（SCr）、血清β2微球蛋白（Sβ2MG）、尿免疫球蛋白G（UIgG）、尿β2微球蛋白（Uβ2MG）、内生肌酐清除率（Ccr）之间的关系。方法用放射免疫分析（RIA）法测定Sβ2MG、UIgG、Uβ2MG及酶联免疫吸附实验（ELISA）法测定SCysC，对30例健康人（N组）及109例糖尿病（DM）患者进行以上指标测定，109例糖尿病患者按照UAER被分成UAER〈20μg／min（NDN组），UAER20～200μg／min（DN组），并进行相关分析。结果DN组中的UAER、SCysC、Sβ2MG、UIgG比NDN组明显升高，差异有统计学意义（P〈0．01），NDN组中UAER、SCysC、SCr、Sβ2MG、Ccr比N组明显升高，差异有统计学意义（P〈0．01）；DN组比NDN组Ccr有下降趋势，但P〉0．05，差异无统计学意义；在糖尿病患者中，UAER与SCysC、Sβ2MG、UIgG、Uβ2MG、SCr呈正相关（r=0．359，0．508，0．509，0．364，0．236，P〈0．01），Ccr与SCr呈负相关（r=-0.359，P〈0．01），与SCysC呈负相关（r=-0．454，P〈0．01），SCr与SCysC呈正相关（r=0．491，P〈0．01）。结论UAER、SCysC、Sβ2MG可作为监测早期糖尿病肾病较敏感指标，在评估Ccr方面，SCysC与Ccr的相关性更好，优于SCr。Objective To investigate the relationship among urinary microalbumin excretion rate （UAER）, serum cysteine protease inhibitor （SCysC）, serum creatinine （SCr）, serum β2 microglobulin （Sβ2 MG）, urinary immunoglobulin （UIgG）, urinary β2 microglobulin （Uβ2 MG）, and creatinine clearance （Ccr）, which were used for diagnosing early diabetic nephropathy （DN）. Methods 109 patients with diabetes mellitus （DM） and 30 healthy people （normal control, Group N） were involved. 109 patients with DM were divided into 2 groups, Group NDN （UAER 〈20μg/min） and Group DN （20-200 μg/min）. Sβ2MG, UIgG and Uβ2MG, were measured by radioimmunoassay （RIA）, and SCysC was measured by enzyme linked immunosorbent assay （ELISA）. Correlation analysis was performed. Results UAER, SCysC, Sβ2MG, and UIgG were higher significantly in Group DN than those in Group NDN （P〈0.01）. UAER, SCysC, SCr, Sβ2MG, and Ccr were higher significantly in Group NDN than those in Group N （P〈0.01）. There was no significant difference of Ccr between Group DN and Group NDN. In patients with diabetes mellitus, UAER level was positively correlated with SCysC, Sβ2 MG, UIgG, β2 MG, and SCr （r=0. 359, 0. 508, 0. 509, 0. 364, 0. 236,respectively P〈0. 01）, Ccr was negatively correlated with SCr, SCysC（r=0. 359, - 0. 454, P 〈 0. 01）, and SCr was positively correlated with SCysC （r= 0. 491, P 〈0. 01）. Conclusion UAER, SCysC and Sβ2 MG may be used as sensitive indexes of diagnosing early DN. SCysC was correlated with Ccr more closely than SCr.

关 键 词：糖尿病 糖尿病肾病 尿微量清蛋白排泄率 血清胱氨酸蛋白酶抑制剂C 

分 类 号：R587.1[医药卫生—内分泌]