血清胱抑素C尿β_2-微球蛋白和尿NAG酶在糖尿病早期肾损伤中的意义

The significance of CysC,β_2-MG and urinary NAG in early renal damage of patients with diabetes

目的探讨血清胱抑素C(CysC)、尿β2-微球蛋白(β2-MG)和尿N-乙酰-β-D-氨基葡萄糖苷酶(NAGenzymuria)在2型糖尿病早期肾损伤的意义。方法采用免疫比浊法检测尿液微量清蛋白,比色法测定尿NAG,乳胶增强散射比浊法测定血清胱抑素C、尿β2-MG。根据尿清蛋白排泄率(UAER),将Ⅱ型糖尿病患者71例分成两组,即UAER正常组和微量清蛋白尿组,同健康对照组(n=35),进行组间比较。结果 UAER正常组与健康对照组比较,CysC结果已经升高,阳性率为28.5%,但β2-MG,NAG和健康对照组比较差异无统计学意义。微量清蛋白组CysC阳性率为88.5%,β2-MG阳性率为80.0%,NAG阳性率为65.7%,和健康对照组比较差异有统计学意义。结论 血清胱抑素C和β2-MG和尿NAG酶可反映早期肾损害,且升高的程度与肾损伤的程度成正相关。若联合检测,可提高糖尿病肾损伤的早期检出率。

Objective To evaluate serum cystatin C（CysC）,urinary β2-microglobulin（β2-MG） and urinary N-acetyl-β-D-glucosaminidase（NAG） in early renal damage of patients with type 2 diabetes mellitus.Methods We used immunoturbidimetry to test urine microalbumin,and urine NAG was tested by colorimetric method,serum CysC and urineβ2-MG were measured by latex enhanced nephelometric method.According to urine albumin excretion rate（UAER）,71 patients with type 2 diabetes mellitus were divided into two groups,normal UAER group and microalbuminuria group,and the healthy people were as the control group（n=35）,then we compared the results among groups.Results We compared the result of UAER normal group and control group,and the CysC level increased,with the positive rate of 28.5%,but there was no significant difference of the β2-MG,NAG between the two groups.Compared with the control group,the positive rates of CysC,β2-MG,NAG in albumin group were 88.5%,80.0% and 65.7%,respectively,with significant difference.Conclusion Serum CysC,β2-MG and urinary NAG may reflect early renal damage,and the levels of them has a positive correlation with the degree of renal injury.With the joint detection,we can improve the early detection rate of renal injury in patients with diabetes.