尿液微量蛋白4项检测对糖尿病肾病的早期诊断价值

Diagnostic value of four urinary microalbumins detection in early diabetic nephropathy

目的探讨尿微量白蛋白(MA)、尿转铁蛋白(TRF)、α_1-微球蛋白(α_1-MG)及β_2-微球蛋白(β_2-MG)的定量检测对糖尿病肾病(DN)的早期诊断价值。方法根据尿蛋白定性试验将65例2型糖尿病患者分为尿蛋白定性阳性组和阴性组,采用免疫比浊法定量检测65例2型糖尿病患者及30例健康体检人员的MA、TRF、α_1-MG及β_2-MG水平,并对结果进行统计和分析。结果尿蛋白定性阳性组和尿蛋白定性阴性组患者的MA(mg/L:28.6±4.4、11.3±1.9比6.9±1.1)、TRF(mg/L:3.5±0.9、1.3±0.4比1.1±0.3)、α_1-MG(mg/L:28.1±6.3、9.4±2.0比8.2±1.9)及β_2-MG(mg/L:4.77±0.71、1.58±0.39比0.94±0.22)均明显高于正常对照组,且尿蛋白阳性组的这4项微量蛋白水平又明显高于尿蛋白阴性组,差异均有统计学意义(均P<0.05);MA、TRF、α_1-MG及β_2-MG单项检测对2型糖尿病患者诊断的阳性率分别为41.5%、44.6%、38.5%及33.8%,联合检测这4项微量蛋白的阳性率可高达90.5%。结论尿MA、TRF、α_1-MG及β_2-MG是DN的早期诊断的敏感指标,联合检测这4项指标对提高DN的早期诊断以及鉴别其病变部位有重要意义。

Objective To investigate the diagnostic value of urine mircroalbumin （MA）, transferritin （TRF）, α1-microglobulin （α1-MG） and β2-mircroglobulin （β2-MG） for early diabetic nephropathy （DN）. Methods The 65 diabetic patients were divided into positive group and negative group according to the experiment of urine micro protein qualitative. The levels of urine MA, TRF, α1-MG and β2-MG in 65 diabetic patients were measured by immunoturbidimetry. Levels of 30 healthy people were compared as the control group. Results In the positive group and negative group, the levels of urine MA （mg/L： 28.6 ± 4.4, 11.3±1.9 vs. 6.9 ± 1.1）, TRF （mg/L： 3.5 ± 0.9, 1.3 ± 0.4 vs. 1.1 ± 0.3）, α1-MG （mg/L： 28.1 ± 6.3, 9.4 ± 2.0 vs. 8.2 ± 1.9） and β2-MG （mg/L： 4.77 ± 0.71, 1.58 ± 0.39 vs. 0.94±0.22） were higher than those of the control group; and the levels of the positive group were also higher than negative group （all P 〈 0.05）. The positive rate was MA 41.5%, TRF 44.6%, α1-MG 38.5% and β2-MG 33.8%. Total positive rate of combined detection of the four indicators was 90.8%, Conclusion MA, TRF, α1-MG and β2-MG in urine were sensitive indicators for early diagnosis of DN. Diagnosis with the four together might raise the positive rate of early diagnosis and evaluate the severity of the disease.