糖尿病肾病早期诊断价值与临床研究

Early Diagnosis Value and Clinical Study of Diabetic Nephropathy

目的分析尿Ⅳ-C、CERP、NAG在糖尿病肾病(DN)早期诊断价值与临床意义。方法将120例糖尿病患者尿微量白蛋白正常38例(DM-1组)、升高44例(DM-2组)和40名正常人的Ⅳ型胶原(Ⅳ-C)、铜蓝蛋白(CERP)、N-乙酰-B-D-氨基葡萄糖苷酶(NAG)水平、尿微量白蛋白排泄率(UAER),并分析其与血糖、血肌酐、尿素氮等指标的相关性。结果病例组尿Ⅳ-C、CERP和NAG均显著高于正常对照组,DM-2组与DM-1比较,组间差异有统计学意义(P<0.05),且与UAER呈显著正相关;尿微量蛋白升高与血尿素氮、肌酐等呈正相关;联合检测阳性率显著高于单项检测。结论尿Ⅳ-C、CERP、NAG作为DM患者早期肾脏损伤的敏感指标优于尿微量蛋白,其含量高低与肾脏损害程度呈正相关性,联合检测的效果更佳。

Objective To study the early diagnostic value and clinical significance of urinaryⅣ-C,CERP and NAG in diabetic nephropathy(DN).Methods All 120 cases of diabetic patients with normal urinary albumin in 38 cases(DM-1 group),44 cases(DM-2 group)and 40 normal people with typeⅣcollagen(Ⅳ-C),ceruloplasmin(CERP),N-acetyl-B-D-glucosaminidase(NAG)levels,urinary microalbumin excretion rate(UAER),and analysis of its correlation with blood glucose,serum creatinine,urea nitrogen and other indicators.Results UrineⅣ-C,CERP and NAG were significantly higher in the case group than in the normal control group.The difference between the DM-2 group and the DM-1 group was statistically significant(P<0.05),and was significantly different from UAER.Positive correlation;elevated urine microprotein,positively correlated with blood urea nitrogen,creatinine,etc.;the positive rate of combined detection was significantly higher than single test.Conclusion UrineⅣ-C,CERP and NAG are superior to urinary microalbumins as sensitive indicators of early renal injury in DM patients.The increase of urinaryⅣ-C,CERP and NAG is reflected in the degree of renal damage.Combined detection is of great significance in predicting the occurrence and progression of early renal damage in DM.