糖尿病早期肾损害的监测

Renal damage in earlier stage of NIDDM

目的 了解转铁蛋白、视黄醇结合蛋白在糖尿病早期肾损害诊断中的意义。方法 5 2例 2型糖尿病及13例正常人尿中转铁蛋白、视黄醇结合蛋白、白蛋白采用双抗体夹心ELISA法测定 ,放免法测定α1微球蛋白。结果 同对照组相比 ,患者尿转铁蛋白、尿视黄醇结合蛋白、尿α1微球蛋白均增高 ,差异显著 (P <0 0 5 )。A组 2 0例尿白蛋白正常 ,尿转铁蛋白异常者 4 0 % ,尿视黄醇结合蛋白异常者 70 % ,差异显著 (P <0 0 5 )。尿转铁蛋白与尿白蛋白明显正相关 (r =0 70 ,P <0 0 5 )。结论 糖尿病肾小管损害较肾小球损害出现更早 。

Objective To study the clinical significance of determination urinary transferrin?retinol binding protein in earlier diabetic nephropathy.Methods Concentrations of urinary transferrin?urinary retinol binding protein and urinary albumin in 13 healthy subjects and 52 patients with NIDDM were measured by double antibody sandwich ELISA,and urinary α 1 microglobulin was measured by immunoradiometry.Results Compared with control group,there was a significant difference in the levels of urinary transferrin?retinol binding protein?α 1 microglobulin,respectively(P<0 05).In group A,abnormal rate of urinary transferrin was 40%(P<0 05),that of urinary retionol binding protein was 70%(P<0 05)as compared with that of urinary albumin.A postive correlation was found between urinary transferrin and urinary albumin(r=0 70,P<0 05),and between urinary retinol binding protein and α 1 microglobulin(r=0 67,P<0 05).Conclusions Dysfunction of tubules is earlier than that of glomeruli in earlier stage of NIDDM,treatment of diabetic nephropathy should begin at the day when NIDDM have been diagnosed.