多项指标联合检测对糖尿病早期肾损害的诊断价值

THE VALUE OF MULTIPLE ITEMS MONITORING OF EARLY RENAL DAMAGE DIAGNOSIS IN DIABETIC NEPHROPATHY

目的探讨联合检测尿液视黄醇结合蛋白(RBP)、ɑ1-微球蛋白(ɑ1-MG)、微量白蛋白(MA)、N-乙酰-β-D氨基葡萄糖苷酶(NAG)和血清半胱氨酸蛋白酶抑制剂C(CysC)在糖尿病早期肾损害诊断中的价值。方法对68例糖尿病早期肾损害患者和30例健康人标本的尿液RBP、ɑ1-MG、MA、NAG和血清CysC进行测定,并分析单项指标及五项指标联合检测对糖尿病早期肾损害的诊断价值。结果 尿液RBP、ɑ1-MG、MA、NAG和血清CysC在糖尿病早期肾损害患者中均有不同程度增高,与正常对照比较均有显著性差异(p<0.05),五项指标联合检测可显著提高糖尿病早期肾损害的诊断效率(92.1%)。结论尿液RBP、ɑ1-MG、MA、NAG和血清CysC是诊断糖尿病早期肾损害的敏感指标。

Objective To explore the significance of associated monitoring retinol-binding protein（RBP）,ɑ1-microglobulin（MG）,microalbumin（MA）,N-acetyl-β-D-glucosaminidase（NAG） and cystatin C（CysC） in the diagnosis of early renal damage in diabetic nephropathy.Methods The urine levels of RBP,ɑ1-MG,MA,NAG and the serum level of CysC were determined in 30 healthy subjects and 68 patients with diabetic.Results The levels of urinary RBP,ɑ1-MG,MA,NAG and the level of serum CysC in diabetic were significantly higher than those in the control group（p0.05）.Conclusion RBP,ɑ1-MG,MA,NAG and CysC can be used in the diagnosis of early renal impairment in diabetic patients,the combined analysis of three or four of these indicators can increase the positive detection rate.It can also be used to indicate the degree of severity of renal impairment in patients with diabetic nephropathy.