尿Ⅳ型胶原与尿微量白蛋白联合检测对糖尿病肾病的早期诊断价值

EARLY DIAGNOSTIC SIGNIFICANCE OF URINARY TYPE Ⅳ COLLAGEN AND MICROALBUMINURIA DETERMINED FOR DIABETIC NEPHROPATHY

目的 探讨尿Ⅳ型胶原与尿微量白蛋白联合检测对糖尿病肾病的早期诊断价值。方法 采用放免法对 96例 2型糖尿病患者及 4 0例正常人尿Ⅳ型胶原、白蛋白、α1-MG、β2 -MG等指标进行了测定。结果 糖尿病组尿白蛋白排泄率、尿Ⅳ型胶原显著高于正常对照组 ,随蛋白质排泄率的增加 ,尿Ⅳ型胶原递增。尿α- MG、β2 -MG、HbA1c、糖尿病病程均呈显著正相关。结论 2型糖尿病合并肾病 ,肾小管病变可能先于肾小球病变而存在。尿Ⅳ型胶原可预示糖尿病肾病的发生和发展。

Objective To investigate the value of the determination of urinary type Ⅳ collagen(CⅣ) and microalbuminuria in early diagnosis of diabetic nephropathy(DN).Methods Excretion of urinary type Ⅳ collagen,albumin,α 1-microglobulin(α 1-MG) and β 2-microglobulin(β 2-MG) were measured with RIA in 96 cases with type 2 diabetes mellitus and 48 normal subjects as controls,and fasting plasma glucose(FPG) and HbA 1c were measured in every case.Results The excretion of urinary CⅣ,albumin,α 1-MG,β 2-MG in total 96 diabetic patients was significantly higher than that in controls,and exctetion of urinary CⅣ,α 1-MG,β 2-MG increased in accord with the increasing of the excretion of urinary albumin(UAE).The excretion of urinary CⅣ was positively correlated with UAE,urinary α 1-MG,β 2-MG,HbA 1c and diabetic duration respectively.No correlation existed between FPG and excretion of CⅣ or UAE.Conclusion Tubulopathly may precede glomerular dysfunction in type 2 diabetic patients,and excretion of urinary CⅣ may indicate the onset and development of DN.The excretion of urinary CⅣ may be amarker for early diagnosis of DN,and may be more sensitive than UAE.Combined determination of urinary CⅣ and UAE may contribute to early diagnosis of DN,and may be more sensitive than UAE.