尿α_1微球蛋白检测在糖尿病肾病早期诊断中的意义

Significance of α_1-microglobulin measurement in urine in the early diagnosis of diabetic nephropathy

目的 探讨α1 微球蛋白 (MG)在糖尿病肾病早期诊断中的价值。方法 选择 1996年 1月至 1998年 9月收治临床确诊Ⅱ型糖尿病 (DM )的患者 2 17人。剔除 :①尿蛋白定性阳性或可疑阳性 ;②肝胆疾患、泌尿系感染、糖尿病酮症、高血压、心功能不全的患者。晨起排尿后饮水 40 0～ 5 0 0ml、1h后 ,留尿送检 ,同时送检血TG、Ch、GHb等。采用多元回归分析 ,判断其他各变量与应变量ALB间的关系。根据尿白蛋白排泄率分为正常白蛋白尿组、微量白蛋白尿组和临床糖尿病肾病组。结果 与ALB相关联的 5个因素中 ,以α1 MG关联度最大 ,各组间α1 MG值差异有显著性 ,与我院内科实验室提供的正常值比较 ,UAER正常时 ,α1 MG已呈现出明显异常 (P <0 0 1)。结论 尿α1 MG可作为糖尿病肾病早期诊断的灵敏指标。

Objective To probe the significance of α 1-MG in the early diagnosis of diabetic nephropathy. Methods 1217 patients diagnosed as DM(Ⅱ) sufferers were selected. It was made sure that they were not: positive or possibly positive according to qualitative analysis of protein through urine. Patients of liver or gallbladder diseases, urinary system infection, diabetic ketoacidosis, hypertension or cardiac insufficiency. Urine samples from these patients were adopted one hour after they got up in the morning, urinated and drank 400～500 ml water each. Urine samples were examined, and meanwhile blood TG, Ch, GHb. were also examined. The results were analyzed by pluralistic regression analysis to judge the relationship between variable ALB and other variables. According to UAER, the patients were divided into three groups: normal, small-amount and clinical diabetic nephropathy. Results Of the five factors related to ALB, α 1-MG was the closest. The difference between α 1-MG values from all groups were conspicuous. Compared with the normal values provided by the internal medicine laboratory of our hospital, when UAER is normal, α 1-MG appears to be apparently unusual (P<001). Conclusion Urine α 1-MG may be an effective index for the early diagnosis of diabetic nephropathy.