尿微量清蛋白联合糖化血红蛋白在糖尿病肾病早期检测中的临床意义

Clinical Significance of Microalbuminuria Joint HbA_(1c) in Early Detection of Diabetic Nephropathy

目的 探讨尿微量清蛋白联合糖化血红蛋白在糖尿病肾病早期检测的价值,以期早期诊治,降低并发症发生率。方法 选取2013年11月—2016年1月进行治疗的糖尿病肾病患者76例为病例组,根据空腹血糖（FPG）水平进一步分为A亚组（7.1-10.0 mmol/L）、B亚组（10.1-13.1 mmol/L）、C亚组（〉13.1 mmol/L）。另选取同时期本院进行体检的健康成年人75例作为对照组。检测尿微量清蛋白、糖化血红蛋白。结果 病例组尿微量清蛋白、糖化血红蛋白较对照组升高（P〈0.05）。C亚组尿微量清蛋白、糖化血红蛋白较A亚组和B亚组升高（P〈0.05）。尿微量清蛋白检测糖尿病肾病阳性率为40.79%（31/76）,糖化血红蛋白检测糖尿病肾病阳性率为38.16%（29/76）,联合检测糖尿病肾病阳性率为97.36%（74/76）,联合检测糖尿病肾病阳性率较尿微量清蛋白、糖化血红蛋白升高（P〈0.01）。结论 糖尿病肾病患者尿微量清蛋白、糖化血红蛋白明显升高,联合检测对早期糖尿病肾病有重要诊断价值。

Objective To study the value of microalbuminuria joint HbA1c in early detection of diabetic nephropathy, early diagnosis and treatment to reduce the incidence of complications. Methods 76 cases of diabetic nephropathy as case group from April 2010 to April 2013 were selected, divided into A subgroup （7. 1 - 10. 0 mmol/L） , B sugroup （10. 1 - 13. 1 mmol/ L） and C subgroup （ 〉13. 1 mmol/L） based on fasting plasma glucose （ FPG） level. At the same time we examined 75 cases of healthy adults as control group. Microalbuminuria and HbA1c were detected. Results Microalbuminur ia and HbA1c in case group were higher than those in control group （ P 〈 0. 05 ） . Microalbuminuria and HbA1c in C subgroup were higher than those in A subgroup and B subgroup （P 〈0. 05 ）. The diabetic nephropathy positive rate by microalbuminuria was 40. 79% （31/76） , the diabetic nephropathy positive rate by HbA1c was 38. 16% （29/76） , the diabetic nephropathy positive rate by microalbuminuria joint HbA1c was 97. 36% （74/76） , the diabetic nephropathy positive rate by microalbuminuria joint HbA1c was higher than that by microalbuminuria and HbA1c （ P 〈 0. 01 ）. Conclusion Diabetic nephropathy patients with higher microalbuminuria and HbA1c, the joint examination has important diagnostic value for early diabetic nephropathy.