2型糖尿病患者尿微量蛋白、尿酶检测的临床意义

目的探讨2型糖尿病患者尿微量白蛋白（mAlb）、N-乙酰--βD-氨基葡萄糖苷酶（NAG）检测的临床意义。方法对101例2型糖尿病患者（根据尿蛋白定性的有无分为尿蛋白定性阴性组51例和尿蛋白定性阳性组50例）和70例健康体检者（正常对照组）采用免疫比浊法,使用全自动生化分析仪检测尿mAlb水平;采用速率法检测尿NAG水平;尿蛋白定性采用干化学法检测。结果尿蛋白定性阴性组、尿蛋白定性阳性组尿mAlb水平、尿NAG活性均明显高于正常对照组（均P〈0.01）;尿蛋白定性阴性组尿mAlb、尿NAG与尿mAlb＋尿NAG的阳性率分别为41.18%、37.25%、62.75%,尿蛋白定性阴性组尿mAlb、尿NAG阳性率均明显低于尿mAlb＋尿NAG的阳性率（均P〈0.05）。结论尿蛋白定性阴性不能除外糖尿病患者早期肾损伤,尿mAlb、尿NAG联合检测对早期发现糖尿病肾病具有重要意义。

The Detection of the Urine Microprotein and Urine Enzymein Patients with Type 2 Diabetic and Its Clinical Significance

Objective To explore the clinical significance of urine microalbumin（mAlb）and urine N-acetyl-beta-D-glucosaminidase（NAG）as a biomarker of the renal early impairment in type 2 diabetic patients. Methods Sample were collected from 101 type 2 diabetic cases（ in accordance with qualitative detection of urine protein availability is divided into qualitative negative group 51 cases and positive group 50 cases） and 70 healthy controls group,then the urine mAlb level was detected by immunoturbidimetry, urinary NAG activity was assessed by the rate assay, the urine mAlb level and urinary NAG activity were detected by automatic biochemical analyzer;and qualitative urine protein was detected by dry chemical assay. Results Compared with health control group,Urine mAlb and urine NAG are all detected to be higher in qualitative urine protein negative and positive in diabetic patients group,and the differences have statistic significance（all P〈 0.01）. Qualitative urine protein-negative group of diabetic patients, positive rate of urine mAlb, urine NAG and urine mAlb＋urine NAG were 41.18% ,37.25% and 62.75% ,positive rate of urine mAlb, urine NAG were significantly lower than positive rate of urine mAlb＋urine NAG（all P〈 0.05）. Conclusion The negative result of qualitative urine protein can not exclude early nephropathy of diabetic. Union detection of urine mAlb and urine NAG is of great importance for early discovery diabetic nephropathy.