四种药物联合检测对2型糖尿病早期肾损伤诊断的探讨

目的:探讨尿微量白蛋白(mALB)、α1-微球蛋白(α1-MG)、β2-微球蛋白(β2-MG)和N-乙酰-β-D氨基葡萄糖苷酶(NAG)联合检测对5年以上病程2型糖尿病(NIDDM)患者肾损伤早期诊断的价值。方法:采用免疫透射比浊法和比色法检测80例2型糖尿病患者及60例健康体检者晨尿mALB、α1-MG、β2-MG和NAG含量。结果:2型糖尿病患者尿mALB、α1-MG、β2-MG、NAG水平均显著高于对照组(P<0.01)。NIDDM患者中,尿α1-MG增高的阳性率为37.5%,4项指标的单项或联合检测的敏感性远远高于常规尿蛋白测定,单项检测的阳性率较低,联合检测阳性率较高,其中α1-MG+β2-MG+NAG模式高达57.5%,4项联检阳性率达63.75%。结论:尿mALB、α1-MG、β2-MG和NAG是NIDDM患者早期肾损害的敏感指标,联合检测3项~4项指标有较高的阳性率,对于2型糖尿病患者早期肾损伤诊断有一定的临床意义。

The Analysis on Early Diagnosis of Diabetic Nephropathies by Mutiple Tumor Markers with Urinary mALB、α1-MG、β2-MG and NAG

Objective To study the role of combined urinary mALB、α_1-MG、β_2-MG and NAG for diagnosis of early renal disease with more than 5 years in type 2 diabetes mellitus. Methods by determine 80 type 2 diabetes mellitus patients and 60 normal persons urinary mALB、α_1-MG、β_2-MG and NAGwith Immunoturbidimetric and Colorimetry assay. Results The levels of urinary mALB、α_1-MG、β_2-MG and NAG type 2 diabetic group were higher than those in the control(P<0.01). Positive rate of α_1-MG was 37. 5%, Positive rate of the three items together(α_1-MG +β_2-MG +NAG) were 57.5% and the four items together were 63.75%. Conclusion Urinary mALB、α_1-MG、β_2-MG and NAG is sensitive and reliable for diagnosis of early renal disease , Positive rate of determine three or four together were higher and for diagnosis of early renal disease in type 2 diabetes mellitus have clinical significance.