尿液微量蛋白质检测评估糖尿病早期肾脏损害

Detected urinary microproteins for assessment of early diabetic renal damage

目的 探讨糖尿病早期肾损害的敏感指标。方法 采用酶联免疫吸附法测定尿中转铁蛋白(TRF)、微量白蛋白 (mALB)、视黄醇结合蛋白 (RBP)和α微球蛋白 (A1M )。结果 尿蛋白定性为阴性时 ,尿TRF增高 ,与正常对照相比有显著差异性 (P >0 0 0 1 ) ,尿mALB、RBP和AlM与正常对照无差异(P >0 0 5 ) ;尿TRF增高患者尿液中RBP增高者仅占 6 8 9%,而尿RBP增高患者尿液中TRF增高达91 6 ;尿蛋白定性为阳性时 ,尿TRF、mALB、RBP和AlM均增高 ,与尿蛋白定性阴性时相对应各组值比较有显著差异 (P <0 0 0 1 ) ,同时尿TRF与RBP和RBP与AlM均呈正相关 (r =0 6 4 ,t=4 5 7,P <0 0 0 1 ;r=0 72 ,t=5 5 2 ,P <0 0 0 1 )。结论 尿TRF和RBP是糖尿病早期肾小球和肾小管损害的指标 ,糖尿病的肾损害先是肾小球继之损害肾小管。

Objective To provide detection markers for early diabetic renal damage.Methods Urinary transferrin(TRF)?retinol-binding protein(RBP)and alphl-microglobulin(A1M) were determined with enzyme-linked immunosorbent assays.Results In urinary albumin negative groups,the levels of urinary TRF was higher than that in the control(t′=5.2,t a′=3.69,P<0.001),but the levels of RBP and A1M did not increased(P>0.05).However the levels of urinary TRF?RBPand A1M were higher than those in the groups of urinary albumin negative(t′=7.56,t a′=3.6,P<0.001;t′=5.19,t a′=3.64,P<0.001:t′=5.32,t a′=3.65,P<0.001).In addition,a positive correlations between TRF and RBP(r=0.64,t=4.57,P<0.001)as well as between RBP and A1M (r=0.72,t=5.58,P<0.001) were observed.Conclusion: Urlnary TRF and RBP were sensitive markers in detecting early diabetic renal damage in glomerular filtration and tubular reabsorption function.Significant found that the tubulapathy was in subsequent development of glomerulopathy in diabetic.