糖化血红蛋白、尿微量白蛋白检测在糖尿病肾损害中的应用价值

Application value of glycosylated hemoglobin and urinary microalbumin in diabetic renal damage

目的：探讨尿微量白蛋白检测对糖尿病早期肾损害的应用价值及其与糖化血红蛋白水平的关系。方法选择临床确诊的2型糖尿病（T2DM）患者98例，按糖化血红蛋白（HbA1c）的检测结果分为 A、B、C 3组：A 组HbA1c≤7．0％（17例），B 组 HbA1c7．1％～10％（37例），C 组 HbA1c＞10％（44例），另选取40名健康体检者作为对照组，检测各组24 h 尿微量白蛋白（24 h UmAlb）水平，并对其24 h 尿总蛋白（24 h U-TP）、血清肌酐（Scr）、尿素氮（BUN）水平进行检测和分析比较。结果T2DM 患者各组和对照组相比，Scr、BUN 差异无统计学意义（P ＞0．05），各组24 h UmAlb、24 h U-TP、HbAlc 差异有统计学意义（P ＜0．01）；T2DM 患者24 h U-TP、24 h UmAlb的阳性率分别为72．45％和55．10％，差异有统计学意义（P ＜0．05）；T2DM 患者 A、B、C 组间24 h UmAlb 阳性率差异有统计学意义（P ＜0．05）。结论糖尿病患者24 h UmAlb 检测较24 h U-TP 更为敏感，对早期肾损伤具有重要的临床诊断价值。控制 HbAlc 水平有利于防止24 h UmAlb 产生，保护肾功能。

Objective To explore the application value of urinary microalbumin in early renal damage of dia-betic and its relation with the level of glycosylated hemoglobin.Methods Selected 98 cases with the clinical definite type 2 diabetes mellitus （T2DM）and divided them into three groups according to their gly-cosylated hemoglobin （HbAlc）lever：Group A≤7.0% （17 cases）,Group B 7.1%-10% （37 cases）,and Group C＆gt;10% （44 cases）;40 healthy persons were selected as control group.Detected and analyzed the 24 hour′s urinary microalbumin （UmAlb）level,the 24h of urinary total protein （U-TP）,serum creatinine （Scr）and urea nitrogen （BUN）of all the groups.Results No significant difference of Scr,BUN was found in T2DM groups and control group （P ＆gt;0.05）,but there was significant difference of 24 h UmAlb, 24 h U-TP and HbA1c in all the groups （P ＆lt;0.01）;The positive rate of 24 h U-TP and 24 h UmAlb in T2DM patients were 72.45% and 55.10% with significant difference （P ＆lt;0.05）;the positive rate of 24 h UmAlb had significant differences in Group A,B,C of T2DM patients （P ＆lt;0.05）.Conclusion Detection of 24 h UmAlb in patients with diabetes was more sensitive than 24 h U-TP,which had important clinical＆amp;nbsp;value in the diagnosis for the early renal damage.To control the level of HbAlc was helpful for preventing the production of 24 h UmAlb and protecting the renal function.