糖尿病早期肾损害的诊断指标评价  

Evaluate on diagnostic indicator to early renal damage in diabetes

作　　者：柴琳[1] 张俊[1] 杨汝文[1] 

机构地区：[1]云南省昆明市中医医院检验科,650011

出　　处：《检验医学与临床》2010年第14期1465-1466,1468,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨诊断糖尿病早期肾损害的敏感指标。方法将98例糖尿病肾病患者分为糖尿病临床肾病组31例和无临床肾病组61例;另选择20例健康体检者为对照组。采用速率法检测尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG),乳胶增强免疫比浊法检测尿微量清蛋白(mALB),γ-谷氨酰-3-羟基-4-硝基苯胺法检测γ-谷氨酰转移酶(GGT),苦味酸法检测尿肌酐(Cr),并将结果进行比较。结果健康对照组尿NAGC为(7.1±3.8)U/g.Cr,尿mALBC为(6.7±2.9)mg/g.Cr,尿GGTC为(43.6±15.7)U/g.Cr。糖尿病无临床肾病组尿NAGC、mALBC与健康对照组比较差异有统计学意义(P<0.01),尿GGTC与健康对照组比较差异无统计学意义(P>0.05)。糖尿病临床肾病组尿NAGC、mALBC和GGTC均较健康对照组显著增高。尿NAG在糖尿病无临床肾病组和临床肾病组中阳性率分别为61.2%和80.6%;尿mALB的阳性率分别为52.2%和71.0%;尿GGT的阳性率分别为34.3%和58.1%。NAG和mALB联合检测与NAG、mALB和GGT3项指标联合检测阳性率相同。结论尿NAG和mALB联合检测是诊断糖尿病早期肾损害的敏感指标。Objective To investigate the diagnostic indicators of early diabetic kidney damage.Methods 98 cases of diabetic nephropathy were divided into two groups,67 cases of clinical nephropathy and 31 cases of non-clinical nephrology group;20 cases as the healthy control group.The rate method was used to measure urinary N-acetyl-β-D-glucosaminidase （NAG）,latex enhanced immunoturbidimetric assay for measuring urinary microalbumin （mALB）,γ-glutamyl-3-hydroxy-4-nitroaniline for measuring γ-glutamyl transferase （GGT）,picric acid method for measuring urinary creatinine （Cr）,the results were compared.Results In normal control group,urine NAGC was （7.1 ± 3.8）U/g·Cr,urine mALBC of （6.7±2.9）mg/g·Cr,urine GGTC of （43.6±15.7）U/g·Cr.In diabetic without clinical nephropathy group,urinary NAGC,mALBC had significant difference compared with normal control group （P〈0.01）;urine GGTC compared with normal control group had no statistically significant difference （P〉0.05）.In the clinical diabetic nephropathy group,urine NAGC,mALBC and GGTC were significantly higher than those in the normal control group.Urinary NAG in diabetic without clinical nephropathy and clinical nephropathy groups,the positive rates were 61.2% and 80.6%; urine mALB positive rates were 52.2% and 71.0%; urine GGT positive rates were 34.3% and 58.1%.NAG and mALB joint detection had positive rate of NAG,mALB and GGT combined detection.Conclusion Urinary joint detection of NAG and mALB is a sensitive indicator of early kidney damage in diabetes.

关 键 词：糖尿病肾病 清蛋白尿 乙酰氨基葡糖苷酶 Γ-谷氨酰转移酶 肌酸酐 早期诊断 

分 类 号：R446.12[医药卫生—诊断学] R587.24[医药卫生—临床医学]