2型糖尿病患者晨尿Alb/α_1-mG比值的临床分析

Clinical Analysis of Urinary Albumin/Microprotein in Patients with Type 2 Diabetes Mellitus

目的探讨2型糖尿病早期肾损害的部位。方法同期检测33例2型糖尿病患者和20例正常人晨尿A lb/Cr比值、A lb和α1-mG浓度,并计算A lb/α1-mG比值。结果(1)2型糖尿病正常白蛋白尿组晨尿α1-mG浓度比对照组显著增高;晨尿A lb/α1-mG比值有所下降,但无统计学意义。(2)2型糖尿病微量白蛋白尿组晨尿A lb和α1-mG浓度比对照组显著增高;晨尿A lb/α1-mG比值有所上升,但无统计学意义。(3)2型糖尿病微量白蛋白尿组与2型糖尿病正常白蛋白尿组相比晨尿A lb和α1-mG浓度及A lb/α1-mG比值均有显著升高。结论2型糖尿病在尿白蛋白尚在正常范围时已有近端肾小管受损,在微量白蛋白尿时肾损害以肾小球受损为主。

Objective To investigate the part in early renal damage in type 2 diabetes mellitus. Methods To measure albumin/ereatimine（Alb/Cr）, urinary albumin and al-microglobulin（α1-mG） and count albumin/α1 -microg]obulin（ Alb/α1-mG） from 33 diabetes and 20 normal controls. Results （1） Urinary α1-mG was increased more in diabetes with normal urinary Alb than that in control group; Urinary Alb/α1-mG was decreased, but there was no statistic significance. （2） Urinary Alb and α1-mG were increased more in diabetes with miero-albuminuria than that in control group; Urinary Alb/α1-mG was increased, but there was no statistic significance. （3） Urinary Alb, α1-mG, Alb/α1-mG were increased in patients with micro-albuminuria compared with those with normal albuminuria. Conclusion Type 2 diabetes mcllitus had approximal damage of tubulus renalis when urine albumin is still within normal range, when at micro-albuminuria urine, the kidney injury involves primarily the renal glomerulus.