Ⅱ 型糖尿病中尿微量白蛋白、β_2-微球蛋白检测的临床意义

Clinical Significance of Determining Microalbuminuria and Urinary β 2 Microglobulin in Patients with Type Ⅱ Diabetes

目的研究Ⅱ型糖尿病病人尿微量白蛋白、β２－微球蛋白（β２－ＭＧ）水平与糖尿病（ＤＭ）病程及伴高血压的关系，以尽早发现糖尿病肾病。方法糖尿组（５０例）与正常对照组（３０例）进行比较。根据ＤＭ病程长短分３组比较。ＤＭ伴高血压者与不伴高血压者比较。留检查当天晨尿用放射免疫法测定微量白蛋白、β２－ＭＧ。用ｔ检验对各组数据进行分析。结果糖尿病组与对照组比较尿微量白蛋白、β２－ＭＧ均有显著差异（Ｐ＜０．０１））；尿微量白蛋白随着ＤＭ病程的延长排出增加。当病程＜５年时，与对照组比较无差异（Ｐ＞０．０５）；病程５～１０年尿微量白蛋白明显升高，以后逐年增高。、β２－ＭＧ只在病程＞１０年后才明显升高；ＤＭ伴高血压者较不伴高血压者尿微量白蛋白、β２－ＭＧ均增高（Ｐ分别＜０．０１、＜０．０５）。结论用放射免疫法检测尿微量白蛋白、β２－ＭＧ，方法简单，用于ＤＭ检查可望发现早期糖尿病肾病，对保护肾脏、减少ＤＭ死亡率有重要意义。

Objective\ To study the relation between Microalbuminuria(MAU) and urinary β 2 Microglobulin(β 2 MG) levels in patients with type Ⅱ diabetes and the course of diabetes,so that diabetic nephropathy can be found earlier and to understand how hypertension influence the excretion of urinary β 2 MG and Microalbuminuria in patients with type Ⅱ deabetes.Method\ 50 patients with type Ⅱ diabetes were allocated into 3 groups in accordance with the course of diabetes and compared with each other.Diabetes group(50 cases) compared with 30 cases of normal control group;and the diabetic patients with hypertension compared with diabetic patients without hypertension.The method of deternining urinary β 2 MG and MAU of morning urine by radioimmunoassay (RIA).All were analysed by t test statistically.Results\ 1.Both urinary β 2 MG and MAU levels in patients with type Ⅱ diabetes were markedly higher than that in control group(P<0.01) and the MAU level increased along with the age growing.2.When the course of diabetes was short than 5 years,there is no significant difference between the MAU level in patients with type Ⅱ diabetes and the control group(P>0.05).3.When the course of diabetes were 5～10 years,the MAU level began increasing markedly.4.The β 2 MG level don’t began increasing until the course of diabetes was more than 10 years.5.The urinary β 2 MG and MAU levels in patients with hypertension all were higher than that in diabetic patients without hypertension.Conclusions\ It is concluded that using the simlpe method of RIA to determine the urinary β 2 MG and MAU can early diagnose diabetic nephropathy,to decrease the mortality of diabetes.