血HCY 尿mAlb 尿α1-MG联合检测在糖尿病早期肾病中的意义

目的 探讨血清同型半胱氨酸（Homocycsteine）、尿微量白蛋白（microalbuminuria,mAlb）及尿α1-微球蛋白（Alpha-1-Microglobulim,α1-MG）联合检测在糖尿病患者（Diabetes Mellitus,DM）早期肾损害的诊断价值.方法 研究81例DM患者和30例健康对照组的血清HCY、尿mAlb及尿α1-MG变化,以及三项指标的联合检测.血清HCY采用循环酶法测定、尿mAlb及尿α1-MG采用免疫散射比浊法测定.结果 DM患者蛋白阴性组的血清HCY、尿mAlb及尿α1-MG水平较正常对照组明显升高（P〈0.05）,DM患者蛋白阳性组较正常对照组血清HCY、尿mAlb及尿α1-MG水平升高更加显著（P〈0.01）,且三项联合检测阳性率达88.9%,明显高于单项检测（P〈0.05）.结论 血清HCY、尿mAlb及尿α-1MG水平随糖尿病肾病（Diabetic Nephropathy,DN）的发生以及严重程度逐渐增高,可作为早期诊断DN较敏感的指标;联合检测能明显提高检测阳性率,对监测早期DN的发生和病情发展程度有重要意义.

Objective To study the diagnostic value of the joint detection of serum homocysteine, urine microalbuminuria and urine Alpha - 1 - microglobulim in early diabetic nephropathy. Methods The difference of serum HCY, urine mAlb and urine α1 - MG, among population included 81 patients with diabetes mellitus （DM） , and 30 healthy controls was studied, meanwhile, the rate of combined detection was analyzed. Homocysteine was conducted by enzymatic cycle, and urine mAlb, urine α1 - MG was detected by immunoturbidimetric assay. Results As compared with normal controls, the levels of serum HCY, urine mAlb and urinec^l - MG in in patients with DM whose urinary protein was negative increased （P 〈 0. 05 ）, And the levels of serum HCY urine mAlb and urineα1 - MG in patients with DM whose urinary protein was positive increased more significantly than healthy controls （ P 〈 0.0l ）. Moreover the positive rate of combined detection reached 88.9%, which was significantly higher than that of the individual testing （ P 〈0. 05）. Conclusions With the occurrence of diabetic nephropathy, as well as an increasing severity the levels of serum homocystelne, urine mAlb and urineα1 - MG gradually increase thus they can diagnose early diabetic nephropathy as sensitive indic.ators. And combmed detection can greatly increase the positive rate, which is important in monitoring the occurrence of early diabetic nephropathy and the degree of progression of the disease.