尿微量蛋白联合尿酶诊断糖尿病早期肾损害

Diagnosis of early renal damage due to diabetes with urinary micro-proteins and NAG

目的探讨糖尿病早期肾损害诊断指标。方法对 5 0例正常对照组和 5 0例糖尿病患者采用终点法测定尿N 乙酰 β D 氨基葡萄糖苷酶 (NAG) ,ELISA方法检测尿视黄醇结合蛋白 (RBP)、微量白蛋白 (mALB)和尿转铁蛋白 (TRF) ,比色法测尿肌酐。结果正常对照组尿NAG/Cr为 (0 .5 2± 0 .4 6 )U/mmol,RBP/Cr为 (7.4 6± 5 .0 2 ) μg/mmol,mALB为(3.6 1± 2 .4 6 )mg/L ,TRF/Cr为(0 .0 5± 0 .0 3)mg/mmol;糖尿病患者尿NAG/Cr、RBP/Cr、mALB及TRF/Cr值较正常对照组增高 (P <0 .0 1) ;两项指标联合检测 ,其阳性率分别为 :NAG +mALB 86 % ,NAG +TRF 88% ,NAG +RBP 90 %。结论联合检测尿NAG与RBP是诊断糖尿病早期肾损害的最灵敏与可靠的实验室指标。

Objective To explore the diagnostic markers for early renal damage due to diabetes. Methods End-point method was applied for urinary N-acetyl-beta-D-gluco-saminidase(NAG).Retinal binding protein(RBP), Microalbumin(mALB) and urinary transferrin(TRF) were measured with ELISA, and colorimetry was used for the measurement of urinary creatinine(Cr). Results In normal controls, the levels of urinary NAG/Cr, RBP/Cr, mALB and TRF/Cr were (0.52±0.46)U/mmol, (7.46±5.02)μg/mmol, (3.61±2.46)mg/L and (0.05±0.03)mg/mmol respectively; The levels of urinary NAG/Cr, RBP/Cr, mALB and TRF/Cr in diabetic patients were significantly higher than in control group(P<0.01). The positive rate of measuring NAG+mALB together was 86%, that of measuring NAG+TRF together was 88% and that of measuring NAG+RBP together was 90%. Conclusion The combined measurement of NAG and RBP is the most sensitive and reliable laboratory index to diagnose the early renal damage in diabetic patients.