尿白蛋白，IgG及血、尿β_2－微球蛋白含量在糖尿病肾病早期诊断中的意义

STUDY OF SOME OBJECTIVES FOR THE DIAGNOSIS IN NIDDM PATIENTS WITH DIABETIC NEPHROPATHY AT EARLY STAGE

用放射免疫分析法测定４８例尿蛋白定性阴性的Ⅱ型糖尿病（ＮＩＤＤＭ）患者尿微量白蛋白（Ａｌｂ）、ＩｇＧ，血、尿β＿２－微球蛋白（β＿２－ＭＧ），并与３４例正常人及８例临床糖尿病肾病（ＤＮ）患者比较。结果显示尿Ａｌｂ正常及异常的两组ＮＩＤＤＭ，ＩｇＧ、尿β＿２－ＭＧ均明显增高（Ｐ＜０．０１），血β＿２－ＭＧ尚无变化。而ＤＮ组除尿Ａｌｂ、ＩｇＧ、β＿２－ＭＧ均明显增高外，血β＿２－ＭＧ亦明显升高（Ｐ＜０．００１）。提示反映肾小球病变的Ａｌｂ、ＩｇＧ及肾小管病变的尿β＿２－ＭＧ在糖尿病早期肾病变即可发生改变，而反映肾小球滤过率变化的血β＿２－ＭＧ较晚发生改变。

The levels of microalbumin,IgG. β_2-Microglobulin(β_2-MG) in urine and β_2-MG in serium from 48 patients with NIDDM by negative urinary protein quantily were anal-ysed by radioimmulogic method ,comparing with 34 normal controls and 8 patients with clinicdiabetic nephropathy (DN). The results showed that in normal and abnormal urinary Albunits with NIDDM,the levels of uric IgG β_2-MG were significant higher than that of normalcontrols (P<0.01),but the level of β_2-MG in serium was no change. In DN unit,apart fromaincrease at levels of urinary Alb IgG β_2-MG there was a significant increase in level ofserium β_2-MG. These indicate that the levels of uric Alb and IgG which show glomerulicdefect and β_2-MG which show renal tuher defect have changed in DN early stage,otherwise,the level of serium β_2-MG which show GFR change later.