糖尿病性蛋白尿电荷选择性的研究

CHARGE SELECTIVITY OF PROTEINURIA IN DIABETES

对95例糖尿病患者尿液中不同电荷和(或)不同分子大小的蛋白(白蛋白、IgG_4、总IgG)排泄进行了临定研究.结果显示,尿IgG_4在微量白蛋白尿组已增高,增高程度与白蛋白尿程度及视网膜病变关系密切.原总IgG在大量蛋白尿组才大量增加.IgG4/总IgG比值在微量白蛋白尿组达高峰,其变化有特殊规律.尿IgG_4及IgG_4/总IgG比值是评估早期肾脏蛋白电荷选择性损害和识别早期糖尿病肾病的敏感指标.

The clearance of proteins differing in charge and/or size (IgG4, total IgG and albumin) was evaluated in 95 diabetic patients. Urinary IgG4 values increased in group mi-croalbuminuria. The increased urinary IgG4 excretion correlated significantly with the degree of albuminuria and diabetic retinopathy. Urinary total IgG levels increased obviously only in group with massive macroalbuminuria. The IgG4/total IgG ratio was highest in group mi-croalbuminuria, and its change had a special pattern. Urinary IgG4 and IgG4/total IgG ratio may be sensitive parameters in assessing early protein charge-selectivity impairment and in detecting incipient diabetic nephropathy.