糖尿病患者血、尿微球蛋白变化及血微球蛋白与肾小球滤过率的相关性研究

目的　观察糖尿病患者血、尿 β2 微球蛋白 (β2 MG)、尿α1 微球蛋白 (α1 MG)水平变化 ,探讨血 β2 MG与肾小球滤过率 (GFR)之间的相关关系。方法　采用放射免疫分析法及99Tcm—二乙三胺五醋酸 (99Tcm—DTPA)肾动态显像法对 44例糖尿病患者和 2 0名正常人进行血 β2 MG、尿 β2 MG、尿α1 MG及GFR检测及对照分析。结果　 (1)病程 <1年和 >10年糖尿病患者血 β2 MG与GFR有明显的负相关性 (P <0 .0 1) ;(2 )糖尿病患者血、尿 β2 MG及尿α1 MG水平均高于对照组 ,其尿α1 MG水平增高更明显 (P <0 .0 1) ;(3)病程 <1年的糖尿病患者其GFR值高于对照组 ,病程 >10年者其GFR低于对照组。结论　GFR与血 β2 MG具有一定相关性 ,尿α1 MG作为早期诊断糖尿病肾病的指标其灵敏性高于血、尿 β2 MG。

Variability of serum,urinary microglobulin and the relationship between serum microglobulin and glomerular filtration rate in diabetics patients

Objective　To observe the variability of serum and urinary β2-microglobulin(β2-MG),urinary α1-microglobulin(α1-MG) and study the relationship between serum β2-MG and glomerular filtration rate (GFR) in diabetic patients.Methods　The serum β2-MG,urinary β2-MG,urinary α1-MG acquried by radioimmunoassay and GFR acquired by99Tcm diethylenetriamine pentaacetic acid (99Tcm-DTPA),renal dynamic imaging were measured in 44 diabetics and 20 normal subjects.Results　(1)The serum β2-MG had significantly negative correlation with GFR (P<0.01) in diabetics who had lasted less than 1 year or more than 10 years.(2)The level of serum β2-MG,urinary β2-MG and urinary α1-MG in diabetic group was significant higher than that of control group, especially urinary α1-MG(P<0.01).(3)The value of GFR in diabetics lasted less than 1 year was higher than that of control,but inverse in diabetics lasted more than 10 years.Conclusion　The level of serum β2-MG was correlated with GFR to some degree.Urinary α1-MG might be used as a sensitive marker for early diagnosis of diabetic nephropathy.