肾脏病及糖尿病尿微量蛋白检测的临床意义

A clinical significance of urine microprotein RIA for patients with renal disease and diabetes mellitus

目的探索五种尿微量蛋白检测在肾脏病及糖尿病中的临床意义。方法用放免法测定50例正常人及83例原发性肾疾病、113例2型糖尿病患者尿α1微球蛋白(α1MG)、β2微球蛋白(β2MG)、TH糖蛋白(THP)、白蛋白(Alb)及IgG排泄水平。结果随内生肌酐清除率下降,尿THP排泄水平下降;尿α1MG、(β2MG)、Alb及IgG排泄水平增加,但当肾功能不全时,上述蛋白排泄水平增加不明显(P>005);糖尿病早期,尿α1MG排泄水平已明显增加(P<001)。五种尿蛋白与CCr均相关(P<005～001)。结论五种尿蛋白均系诊断早期肾损害指标,以α1MG最敏感。但不适用于肾功能不全时的判断。

Objective To study the clinical significant of theurine serial microprotein detected in patients with kidneydisease and diabetes mellitus.Methods 83 cases primarykidney disease patients,113 cases diabetes mellitus(2 type) and 50 cases healthy adults as normal contrast the urine excretive levels of α_1-microglobulin(α_1-MG),β_2-microglobulin(β_2-MG),tamm-horsfall glycoprotein(THP),Alb and IgG were deteeted by used radioimmunoassay(RIA).Results Theresulits showed that followed to the decrease in endogenous creatinine clearance rate(CCr),the urine excretive levels of α_1-MG,β_2-MG,Alb and IgG were increased gradually.But when patients with renal insufficieney,the urine excrtive levels of microprtein did not obviously increase(P>0.05).In early diabetes mellitus patients,the urine α_1-MG have been increased obviously(P<0.01).The urine five microprotein have correlation with the CCr(P<0.05～0.01).Conclusions All urine five microprotein are early indexs that reflect that renal danage,and α_1-MG excreative levels determined was most sensitivity.But it did not adapt to the patients when their are with renal insuffici-enay.