尿总蛋白肌酐比分组评价糖尿病早期肾损伤

Group-discrimination of Early Diabetic Renal Injury by Means of Urinary Protein/Creatinine Ratio

目的探讨以尿总蛋白肌酐比(TPCR)分组评价糖尿病早期肾损伤的应用价值。方法分析61例正常组和113例2型糖尿病(2型DM)组,测量其尿液5项指标;以尿TPCR分≥200mg/gCr组与<200mg/gCr组2组,分析113例与另外67例2型DM患者组,测量其尿TPCR、α-L-岩藻糖苷酶(AFU)、亮氨酸氨基肽酶(LAP)、β2-微球蛋白(β2-MG)、尿微量清蛋白(mAlb)、尿转铁蛋白(TF)和血肌酐(Cr)、血清胱抑素-C(CysC)各5～6种指标。结果正常对照组与2型DM患者组、113例2型DM患者TPCR≥200mg/gCr组与TPCR<200mg/gCr组,其尿TPCR、mAlb、β2-MG、LAP、AFU5种指标均跟随TPCR而显著增高,统计学差异显著(P<0.001)。67例2型DM患者TPCR≥200mg/gCr组尿TPCR、mAlb、TF以及血清CysC均高于TPCR<200mg/gCr组,统计学差异明显(P<0.05)。结论以TPCR200mg/gCr分组或为界线是判别糖尿病人早期肾损害程度的可靠指标。

ObjectiveTo evaluate the early kindney injury by means of urinary protein/creatinine ratio（TPCR, 200mg/gCr）through group-discrimination in mellitus diabetes patients. MethodsQualitative analysis was carried out with urine 5-6 item indexes in 113 cases of diabetes mellitus , 61 cases of heallthy people and other 67 cases of diabetes mellitus patients. 2 groups were divided by means of urinary protein/creatinine ratio（TPCR, 200mg/gCr）.ResultsIn 113 cases of diabetes mellitus , urine TPCR, mAlb, β2-MG, LAP and AFU of 38 cases in TPCR≥200mg/gCr group were significantly higher than those of 75 cases in TPCR〈200mg/gCr group, and there was markable difference（P〈0.001）. The result was same as above between 61 cases of healthy people and 113 cases of diabetes mellitus（P〈0.001）. For 67 cases of diabetes mellitus , urine TPCR, mAlb , TF, serum CysC of 15 cases in TPCR≥200mg/gCr group were also higher than those of 52 cases in TPCR〈200mg/gCr group, and there was significant difference in statistics（P〈005）. ConclusionIt is a dependable method to distinguish early renal injury by grouping with TPCR 200mg/gCr in diabetes mellitus.