2型糖尿病患者肾小管标志蛋白检测的临床意义  

Clinical significance of measurement of renal tubular marker proteins in patients with type 2 diabetes mellitus

作　　者：叶山东[1] 陈燕[1] 李素梅[1] 杨静[1] 邢学农[1] 汤涛[1] 

机构地区：[1]安徽省立医院内分泌科,230001

出　　处：《中国糖尿病杂志》2000年第3期142-144,共3页Chinese Journal of Diabetes

基　　金：安徽省卫生厅科研基金

摘　　要：目的　通过测定尿肾小管间质标志蛋白以探讨 2型糖尿病患者肾小管间质病变。方法　同期测定 2 15例 2型糖尿病 2 4小时尿白蛋白 (2 4h UAE)、视黄醇结合蛋白 (RBP)、α1 -微球蛋白 (α1 - MG)、β2 -微球蛋白 (β2 - MG)、Tamm-Horsfall糖蛋白 (THP)、尿糖 (UG)和肌酐清除率 (Ccr)。结果　 12 15例 2型糖尿病患者 2 4h URBP、2 4h Uα1 - MG和2 4h Uβ2 - MG增高的发生率分别为 39.5 %、45 .1%、34.4% ,且其排泄增高的发生率均随 2 4h UAE的增加而增高 ;2 4hTHP排泄降低的发生率为 40 .0 % ;2在微量和大量白蛋白尿患者中 ,2 4h Uα1 - MG增高亚组与正常亚组比较 ,Ccr明显降低 ,P<0 .0 5 ;3 2 4h URBP、2 4h Uα1 - MG、2 4h Uβ2 - MG和 2 4h UTHP排泄与 2 4h UG无相关性。结论　 2型糖尿病肾脏病变除肾小球病变之外 ,肾小管间质病变亦相当常见 ,甚至早于肾小球病变 。Objective To investigate tubular interstitium damage in patients with type 2 diabetes mellitus by measuring tubulointerstitium marker proteins.Methods 24 hour urinary albumin excretion (UAE)、retinol binding protein、α 1 microglobulin (α 1 MG)、β 2 microglobulin (β 2 MG)、Tamm Horsfall glycoprotein (THP)、urinary glucose (UG) and creatinine clearance rate (Ccr) were measured in 215 patients with type 2 diabetes mellitus.Results ①The raised prevalence rates of 24hURBP、24hUα 1 MG and 24hUβ 2 MG in 215 diabetic patients were 39.5%、45.1%、34.4%,respectively,and all the indexes increased with the increase of 24hUAE.The prevalence rate of decreased 24hUTHP was 40.0% ;②Among the patients with micro and macro albuminuria,Ccr in patients with raised 24hUα 1 MG decreased significantly in comparison with the patients with normal 24hUα 1 MG, P <0.05;③24hURBP、24hUα 1 MG、24hUβ 2 MG and 24hUTHP had no relationship with 24hUG.Conclusion The tubulointerstitium damage was rather common in type 2 diabetics except diabetic glomerulosclerosis,even earlier than glomerulus damage and may contribute to a certain extent to the reduction of renal function.

关 键 词：糖尿病 肾小管间质 尿蛋白 

分 类 号：R587.2[医药卫生—内分泌]