尿蛋白电泳与尿Alb/Cr比值诊断糖尿病早期肾损伤的临床价值

Clinical value of the Urine protein electrophoresis and the urine Alb/Cr ratio for diagnosing the early renal injury of the diabetes

目的探讨尿蛋白电泳与尿白蛋白(Alb)/肌酐(Cr)比值诊断糖尿病(DM)早期肾损伤的临床价值。方法采用十二烷基磺酸钠—琼脂糖凝胶蛋白电泳技术对316例DM患者行尿蛋白电泳检测,免疫比浊法行尿Alb检测,碱性苦味酸法行尿Cr检测,并计算尿Alb/Cr比值。结果尿Alb/Cr比值异常176例,其尿液蛋白图谱中除有深而宽的Alb条带外,还出现大分子和(或)小分子蛋白条带;而其比值正常的140例中,54例除有Alb条带外,还有大分子和(或)小分子蛋白条带。结论尿Alb/Cr比值可作为评价DM早期肾损伤的一项实验室指标;其比值正常不能作为否定DM患者存在早期肾损伤的依据,应加行尿蛋白电泳检测,明确是否存在早期肾损害。

Objective To investigate the early diagnostic evaluation of urinary protein electrophoresis and urine albumin/creatinine ratio in diabetic renal injury. Methods Urine proteins of three hundred and sixteen diabetic mellitus patients were detected by sodium dodecylsulphate（SDS）-agarose gel protein electrophoresis（AGE）. Urine albumin level was detected by immunoturbidimetry, and using alkaline picric acid method for determination of urinary creatinine, and carry out random urinary albumin/creatinine ratio. Results In addition to the deep and wide electrophoresis strip of albumin, were the bands of other maeromolecular and/or small-molecular protein not only detected in 176 urinary samples from the diabetes patients with the abnormal urinary albumin/creatinine ratio, but also in 54 urine samples from the patients with normal urinary albumin/creatinine ratio. Conclusions The urinary albumin/creatinine ratio can be used for the evaluation of early diabetic renal injury in a laboratory, but the normal urinary albumin/creafinine ratio can not be used to deny the existence of a renal injury for the diabetic patients, and urine protein electrophoresis should be considered for further test to determine whether the early renal damage exist or not.