同型半胱氨酸、糖化血红蛋白和尿微量白蛋白联合检测对早期糖尿病肾损伤的诊断价值  

作　　者：徐红珍[1] 王露[1] 马正坤[1] 

机构地区：[1]姜堰市人民医院检验科,225500

出　　处：《当代医学》2012年第26期7-8,共2页Contemporary Medicine

摘　　要：目的探讨同型半胱氨酸(Hcy)、糖化血红蛋白(HbA1c)和尿微量白蛋白(U-mAlb)联合检测对糖尿病早期肾脏损伤的价值。方法分别检测69例2型糖尿病(T2DM)患者(尿蛋白阴性组38例和尿蛋白阳性组31例)和43例健康体检者(对照组)的血清Hcy、HbA1c和U-mAlb的含量。Hcy采用循环酶法,HbA1c采用离子交换液相色谱法,U-mAlb采用速率散射法。结果 DM患者Hcy、HbA1c、U-mAlb的水平明显高于正常对照组(P<0.01),且尿蛋白阳性组升高更为显著(P<0.01),尿蛋白阳性组较尿蛋白阴性组升高明显(P<0.01)。相关分析显示,DM组中血清Hcy、HbA1c与U-mAlb的水平呈正相关(P<0.01),三者联合检测阳性率高达73.6%,明显高于单项检测。结论血清Hcy、HbA1c与U-mAlb的水平与T2DM患者的早期肾损伤程度密切相关,联合检测能大大提高检测阳性率,对于DN的早期诊断,早期治疗及监测有重要意义。Objective To explore the value of associated detection of serum homocysteine glycosylated hemoglobin and microalbuminuria in diagnosis of early diabetic nephropathy.Methods the levels of serum Hcy,HbA1c and U-mAlb were determined in 43 health controls and 69 patients with type 2 diabets mellitus（DM）（38 patients with DM whose urinary protein was negative,31 patients with DM whose urinary protein was positive）,meanwhile,the rate of combined detection was analyzed.Homocysteine was conducted by enzymatic cycle,HbA1c was determined by chromatography and U-mAlb was detected by immunoturdimetric assay.Results As compared with normal controls,the levels of serum Hcy,HbA1c and U-mAlb in DM patients increased（P0.01）,while the levels of serum Hcy,HbA1c and U-mAlb elevated more signifficantly in DM patients whose urinary protein was positive than in patients with DM whose urinary protein was negative（P0.01）.In DM patients,serum Hcy,HbA1c with the levels of U-mAlb have a positive corretation（P0.01）.moreover,the positive rate of combined detected reached 73.6%,which was signifficantly higher than that of the individual tested（P0.01）.Conclusion The levels of serum Hcy,HbA1c and U-mAlb are closely related to the early injure of kidey with DM.And combined detection can greatly increase the positive rate,which is important to the early dianosis,treatment and controlling of DN.

关 键 词：糖尿病肾病 同型半胱氨酸 糖化血红蛋白 尿微量白蛋白 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]