尿IV型胶原在2型糖尿病肾病早期诊断中的意义  

Significance of detecting urinary type IV collagen in diagnosis of early diabetic nephropathy in type 2-diabetic patients

作　　者：周淑红[1] 倪安民[2] 刘静[1] 

机构地区：[1]甘肃省人民医院内分泌科,甘肃兰州730000 [2]兰州医学院第二附属医院内分泌科,甘肃兰州730030

出　　处：《临床荟萃》2003年第24期1393-1396,共4页Clinical Focus

摘　　要：目的　探讨检测尿IV型胶原 (IV C)对 2型糖尿病肾病早期诊断的作用及可能影响因素。方法　选择我院 2 0 0 0年 3～ 12月 2型糖尿病患者 6 0例和健康体检者 2 0例 ,根据尿微量白蛋白排泄率 ,将糖尿病患者均分为 3组 ,每组各 2 0例 ,采用酶联免疫吸附测定法测定尿IV C ,免疫比浊法测尿微量白蛋白 ,同时测定血糖、胰岛素、胰岛素敏感指数、2 4小时动态血压、血脂和相关肾功能指标。结果　正常对照组尿IV C(1.93± 1.12 )mg/L ,糖尿病无肾病组 (6 .6 1± 1.6 4 )mg/L ,糖尿病早期肾病组 (11.35± 3.76 )mg/L。糖尿病临床肾病组 (2 3.4 0± 13.8)mg/L。糖尿病无肾病组中 ,尿白蛋白指数与正常对照组接近 (P >0 .0 5 ) ,而尿IV C的含量与正常对照组比较 ,差异有统计学意义 (P<0 .0 5 )。糖尿病早期肾病组和临床肾病组尿IV C含量明显高于正常对照组 (P <0 .0 1)。糖尿病各组胰岛素敏感指数均低于正常对照组 (P <0 .0 5 )。糖尿病临床肾病组 2 4小时平均血压、白天和夜间平均血压均高于其他 3组 (P<0 .0 5 )。尿IV C多因素相关性分析 ,与病程、尿白蛋白指数、尿α1微球蛋白、尿 β2 微球蛋白、餐后血糖、平均舒张压、夜间血压和N 乙酰 β 葡萄糖酐酶呈正相关关系 ,与胰岛素敏感指数呈负相关关系 (P <0 .0 5 )。Objective To investigate the role of detection of urinary type IV collagen in diagnosis of early type 2-diabetic nephropathy and effective factors. Methods Sixty patients with type 2-diabetes were chosen in our hospital from 2000-03-2000-12 and were divided into three groups by the rate of urinary microalbumin,and twenty healthy people as the control group.Urinary type IV collagen was determined with enzyme-linked immunosorbent assay, urinary microalbumin with immunoturbidimetry,blood glucose,the insulin-sensitivity index, 24 h ambulatory blood pressure,plasum lipid and some corresponding factors of renal functions were measured at the same time.Results The urinary type IV collagen content was ( 1.93± 1.12) mg/L in the control group, ( 6.61± 1.64) mg/L in diabetic with normal nephropathy group, ( 11.35± 3.76) mg/L in early-stage diabetic nephropathy group and ( 23.40± 13.8) mg/L in clinical-stage diabetic nephropathy group.It was higher in the group of normal microalbuminuria diabetic patients than in the control(P< 0.05) while urinary albumin rate was close to between them (P> 0.05),the urinary level of type IV collagen was markedly higher in early-stage and clinical-stage diabetic nephropathy patients than in the control(P< 0.01).The insulin-sensitivity index was lower in three diabetic groups than in the control(P< 0.05).Mean blood pressures including 24 hours, nocturnal time and diurnal time were higher in clinical-stage diabetic nephropathy group than in other three groups(P< 0.05).There was significantly positive correlation between urinary type IV collagen and diabetic duration,urinary albumin rate,urinary α 1-microglobulin,urinary β 2-microglobulin, past blood glucose,24-hour mean diastolic pressure,nocturnal blood pressure,nitrogen-acetyl-β-glucosaminidase.The urinary IV collagen was also negatively related to the insulin-sensitivity index(P< 0.05). Conclusion Urinary type IV collagen is a sensitive indicator in diagnosis of early diabetic nephropathy and monito

关 键 词：糖尿病肾病 胶原 胰岛素 血压监测 便携式 酶联免疫吸附测定 

分 类 号：R587.2[医药卫生—内分泌]