尿沉渣分析和尿微量蛋白在早期糖尿病肾病中的临床应用

Clinical application of urinary sediment and urinary microalbumin in diabetic kidney disease

目的 探讨尿沉渣分析和尿微量白蛋白 (Microalbumin ,mAlb)及尿视黄醇结合蛋白 (retinol bindingprotein ,RBP)在早期糖尿病肾病 (diabetickidneydisease ,DN)中的诊断价值。方法 用日产SysmexUF 1 0 0型尿沉渣全自动分析仪检测尿白细胞(WBC)、红细胞 (RBC)、上皮细胞 (EC)、管型 (CAST) ;mAlb检测用免疫散射比浊法 ;RBP用ELISA法。结果 NIDDM组mAlb/Cr、RBP/Cr、WBC较正常对照组有显著的增高 ,RBP/Cr随mAlb/Cr增加而显著增高 ,而WBC与mAlb/Cr无相关性 ;RBC、EC、CAST在正常对照组与NIDDM组中无明显差异。结论 在糖尿病早期肾损害时mAlb/Cr、RBP/Cr为敏感的指标 ,尿WBC是DM患者应关注的临床指标 ,但WBC、RBC、EC、CAST不能用于DN的早期诊断。

Objective To study the value of urinary sediment (WBC,RBC,EC,CAST),urinary microalbumin(mAlb) and retinol binding protein(RBP) in diagnosis of early renal injure in NIDDM.Methods WBC,RBC,EC,CAST in unrinary sediment were analysied by sysmex UF 100 urine analyzer;mAlb was detected by immuno scattering turbidity assay;RBP was detected by ELISA.Results mAlb/Cr,RBP/cr,WBC in NIDDM group were significantly higher than those of in the control group;RBP/cr increased along with mAlb /cr,while WBC had no correspondence with mAlb /cr.RBC,EC and CAST had no significant difference between in NIDDM group and control group.Conclusion mAlb /cr and RBP/cr in unrine are sensitive indexes in diagnosis of early renal injure in NIDDM;urinary WBC is a clinical index that should be paid attention to;RBC,EC and CAST are not suitable to early diagnosis of DN.