尿α1—微球蛋白检测在糖尿病肾病早期诊断中的意义

目的 探讨α1-MG在糖尿病肾病早期诊断中的价值。方法 选择内分泌科1996年1月至1998年9月收治临床确诊DM(2)的患者217人,剔除:1、肝胆疾患、泌尿系感染、糖尿病酮症、高血压、心功能不全的患者;2、未行尿系列蛋白检查者。晨起排尿后饮水400—500ml一个小时后,留尿送检,同时送检血TG、CH、GHB等。结果处理采用多元回归分析,判断其他各变量与应变量ALB间的关系。根据尿白蛋白排泄率分为正常白蛋白组、微量白蛋白尿组和临床糖尿病肾病组。各指标组间比较采用t检验。结果 与ALB相关联的五个因素中,以α1—MG关联度最大,UAER正常时,α1 MG已呈现出明显异常(P<0.001)。结论 尿α1—MG可作为糖尿病肾病早期诊断的灵敏指标。

The Significance of al - Mlcroglobulin Measurement in Urine for the Early Diagnosil of Diabetic Nephropathy

Objective To probe the significance of α - MG for the early diagnosis of diabetic nephropathy. Methods 217 patients who had been received by the Endocrine section of the Hospital Attached to Anhui Medical University between Jan. 1996 and Sept. 1998 and diagnosed as DM(2)sufferers were seleted. It was made sure that they were NOT : 1 , Patients of liver or gallbladder diseases , urinary system infection , diabetic ketoacidosis, hypertension or cardiac insufficiency. 2 , Patients who had not been examined by analysis of urinary protein. Urine samples from these patients were collected one hour after they got up in the morning , urinated, and drank 400 - 500ml of water. Urine samples were examined , and meanwhile blood TG . CH , GHB etc. were also examined. The results were analysed by Multrariate Regression Analysis to judge the relationship between variable ALB and other variables. Acording to UAER , the patients were divided into three groups : Normal, Small- Amount and Clinical Diabetic Nephropathy. the comparison between the index groups was examined by"t". Result Among the five factors related to ALB , αl- MG was the closest, compared with the normal values provided by the Internal Medicine Laboratory of our hospital. When UAER is normal, α 1 - MG appears to be unusual apparently (P< 0. 001). Conclusion Urinary αl- MG can be a sensitivity index for the early diagnosis of Diabetic Nephropathy.