糖化血红蛋白、同型半胱氨酸及尿微量白蛋白三联检测对2型糖尿病早期肾损伤的诊断价值

The clinical diagnosis value of combination of blood homocysteine,glycated hemoglobin and urinary albumin in type 2 diabetes with early renal damage

目的探讨糖化血红蛋白(Hb A1c)、同型半胱氨酸(Hcy)及尿微量白蛋白(U-m ALB)三联检测法在早期糖尿病肾脏损伤中的诊断价值。方法采用回顾性分析分别检测160例2型糖尿病(T2DM)患者(尿蛋白阴性组84例和尿蛋白阳性组76例)和160例健康体检者(对照组)的Hb A1c、Hcy和U-m ALB的含量,同时对尿蛋白阴性组84例标本分析不同检测指标阳性率。结果研究组Hb A1c、Hcy和U-m ALB阳性率均大于对照组,差异具有统计学意义(P<0.05);尿蛋白阳性组较尿蛋白阴性组三项指标均明显升高,差异具有统计学意义(P<0.05);在T2DM尿蛋白阴性组中三项指标联合检出总阳性率为76.2%,明显高于尿m ALB单项检测的39.3%,差异具有统计学意义(P<0.05)。结论 Hb A1c、Hcy和U-m ALB三联检测法能大大提高2型糖尿病早期肾损伤检测阳性率,值得临床推广应用。

Objective To explore the clinical diagnosis value of combination of blood homocysteine,glycated hemoglobin and urinary albumin in type 2 diabetes with early renal damage. Methods By retrospective analysis,Hb A1 c,Hcy and U-m ALB in 160 patients with type 2 diabetes mellitus（ T2 DM） patients（ 84 cases of urine protein negative group and 76 cases of urinary protein positive group） and 160 healthy subjects（ control group） were detected. At the same time,the positive rate were detected in urine protein negative group,which were record and analysis. Results The positive rate of research group was greater than that of the control group with significant difference（ P 〈 0. 05）. The indicators of urine protein positive group were higher than those of negative group with significant difference（ P 〈 0. 05）. The total positive rate of combined detection in T2 DM negative groups was 73. 6%,which was significantly higher than that of urinary m ALB（ 39. 3 %） with significant difference（ P 〈 0. 05）. Conclusion The combination detection of glycated hemoglobin,homocysteine and urine trace albumin can greatly improve the early renal damage detection rate of type 2 diabetes,which was worthy of clinical promotion.