尿液α_1-微球蛋白测定对糖尿病肾病小管间质病变的诊断价值

Diagnostic value of urinary alpha 1-microglobulin in tubulointerstitial lesion of human diabetic nepgropathy

目的探讨尿液α1-微球蛋白测定对糖尿病肾病小管间质病变的诊断价值。方法选取糖尿病肾病患者60例,分为微量蛋白尿组、临床蛋白尿组、肾功能不全组,每组20例,并设正常对照组20例,分别进行血液生化与尿液α1-微球蛋白测定。结果微量蛋白尿组、临床蛋白尿组、肾功能不全组的尿液α1-微球蛋白分别为(23.3±17.6)mg/24h,(41.9±22.8)mg/24h,(73.6±37.1)mg/24h,均高于对照组的(10.6±4.2)mg/24h,P均<0.01。而且尿液α1-微球蛋白与Scr呈正相关,相关系数为0.37,P<0.01。结论尿液α1-微球蛋白检测可用来判断糖尿病肾病的小管间质损害。

Objective To investigate the value of the determination of urinary alpha 1-microglobulin in the diagnosis of tubulointerstitial lesion of human diabetic nepgropathy （DN）. Methods Sixty patients with DN were divided into three groups, each with 20 cases： group A （the microproteinuria group, with urinary albumin 30~299 mg/24 h）, group B （the clinical proteinuria group, with urinary albumin≥300 mg/24 h and serum creatine115 μmol/L）, group C （the dysfunction group, urinary albumin≥300 mg/24 h and serum creatine 115~445 μmol/L）. Twenty healthy individuals were enrolled as the control group. The levels of urine albumin, alpha 1-microglobulin and serum creatine were determined in the four groups. Results The levels of alpha 1-microglobulin in group A, group B, group C were （23.3±17.6） mg/24 h, （41.9±22.8） mg/24 h, （73.6±37.1） mg/24 h, respectively, which were significantly higher than that in the control group （P0.01）. A positive correlation was found between alpha 1-microglobulin and serum creatine （r=0.37, P0.01）. Conclusion Determination of urinary alpha 1-microglobulin is quite valuable for the diagnosis of tubulointerstitial lesion of human diabetic nepgropathy.