联合检测血同型半胱氨酸、糖化血红蛋白与尿微量白蛋白、β_2-微球蛋白在2型糖尿病早期肾损害诊断的临床价值

The Clinical Diagnosis Value of Combination of Blood Homocysteine,Glycated Hemoglobin and Urinary Albumin,β_2-microglobulin in Type 2 diabetes withEarly Renal Damage

目的探讨血同型半胱氨酸(Hcy)、糖化血红蛋白(HbA1c)、尿微量白蛋白(尿mALB)、尿β2-微球蛋白(尿β2-MG)等指标对2型糖尿病(T2DM)早期肾损害的诊断价值。方法回顾性分析我院196例不同病程2型糖尿病患者及同期158例健康体检人员的HbA1c、血Hcy、尿mALB、尿β2-MG检测结果,并进行统计学处理。结果在T2DM患者中Hcy阳性率(男:47.6%,女:50.5%)最高,且存在性别差异;尿β2-MG阳性率(男:25.2%,女:24.7%)最低;这四项指标中,糖尿病组均明显高于对照组,且随着病程的延长,这些指标较糖尿病初期增高明显。结论定期联合检查T2DM患者HbA1c、血Hcy、尿mALB、尿β2-MG能及时了解糖尿病早期是否存在肾损害及其部位(肾小球、近端肾小管),以便临床医生及时采取有效措施,防止或延缓糖尿病肾病的发生。

Objective To investigate the diagnostic value for early renal damage about the early blood homocysteine （Hcy）, glycated hemoglobin （HbA1c）, urine microalbumin （urinary mALB）, urinary β2-microglobulin （urinary β2-MG） and other indicators in type 2 diabetes （T2DM）. Method A retrospective analysis of 196 cases in different course of type 2 diabetes patients and 158 healthy persons was done, and HbA,c, blood Hcy, urine of mALB, urine β2-MG test were analyzed statistically. Results The positive rate of Hcy in patients with T2DM （male： 47.6% female： 50.5%） was the highest, with gender differences. The positive rate of urine β2-MG （male： 25.2% female： 24.7%） was the lowest. In four indicators, the diabetic group was significantly higher than the control group, and with the extension of the course, these indicators increased significantly. Conclusion The regular and joint examination of HbA,c, blood Hcy, urine of mALB, urine β2-MG in patients with T2DM can understand the early diabetic kidney damage and its parts （glomeruli, proximal tubular）, so that the clinician taken timely and effective measures to to prevent or slow the progression of diabetic nephropatby.