不同指标在糖尿病早期肾功能损害检测中的应用评价  

Evaluate the application of different indexes in early renal injury of diabetes

作　　者：章菊[1] 叶书来[1] 周倩[1] 张昌龙[1] 

机构地区：[1]安徽省立医院(南区)检验科,安徽合肥230000

出　　处：《蚌埠医学院学报》2014年第1期118-120,共3页Journal of Bengbu Medical College

摘　　要：目的：探讨当糖化血红蛋白（HbA1c）异常时,各常规检测指标对糖尿病早期肾功能损害检测的敏感性和特异性.方法：按尿蛋白定性阴性、微量~1＋、2＋~3＋分为A组、B组和C组,另选取30名体检健康者为对照组;尿中五种蛋白（IgG、TRF、mALB、α1-m、β2-m）测定采用免疫散射比浊法、血清Cys]C采用循环酶法、BUN采用酶法、Cr采用苦味酸电极法检测.结果：A、B、C组中各检测指标阳性结果总体有差异（P〈0.01）,A组患者尿IgG、TRF、mALB、β2-m和mALB/Cr阳性率均低于B组和C组（P〈0.05）,而α1-m、CyshC、BUN、Cr阳性率均低于C组（P〈0.05～P〈0.01）;B组和C组各指标阳性率差异无统计学意义（P〉0.05）;糖尿病组与对照组比较各检测指标阳性率差异有统计学意义（P〈0.01）,与对照组比较,糖尿病尿蛋白定性阴性组尿IgG、TRF、β2-m、mALB、mALB/Cr均有较高的阳性率（P〈0.05）.结论：当HbA1c阳性而蛋白定性阴性时,相对于其他检测指标,IgG、TRF、mALB、B2-m、mALB/Cr对糖尿病早期肾功能损害检出更为敏感、特异,单独及联合检测均能有效筛查糖尿病早期肾功能损害.Objective：To explore the sensitivity and specificity of normal testing indexes in the diabetic patients whose hemoglobin Alc（HbAlc） abnormal with early renal damage. Methods： Group were divided according to urinary protein qualitative, group A was negative,group B was trace to 1 ＋ ,group C was 2 ＋ to 3 ＋. Urinary protein（ IgG,TRF,mALB,M-m, 132-m） were detected by using immune nephelometry method ; serum Cys C, BUN and Cr were detected by using the methods of circulatory enzyme, enzyme and picric acid electrode respectively. Results：Each testing index in three groups of diabetes had differences in general （P 〈 0.01 ）, the positive rate of urinary protein of （IgG,TRF, mALB, β2-m and mALB/Cr）in group A was lower than that in group B and C （P 〈 0. 05） ,but α1- m, Cys C, BUN, Cr were lower than that in group C （ P 〈 0. 05 - P 〈 0. 01 ）. There were no significant differences between group B and C in each testing indexes （ P 〉 0. 05 ）. The positive rate of all indexes had significant differences in the group of diabetic and control （ P 〈 0.01 ）. The positive rate of IgG,TRF, β2-m,mALB, mALB/Cr in diabetes with negative urine protein was higher than that in control group （ P 〈 0.05 ）. There was no significant difference in specificity （ P 〉 0. 05 ）. Conclusions： As a testing indexes, TRF, mALB, β2-m, mALB/Cr will be more sensitive and specific when compared with other indexes in detecting early diabetic renal damage whose HbA1 c is positive and urinary protein qualitative is negative. They can be using to screen early diabetic renal damage alone or combination.

关 键 词：糖尿病肾病 糖化血红蛋白 尿蛋白 

分 类 号：R692.39[医药卫生—泌尿科学]