糖化血红蛋白和尿微量白蛋白联合检测对糖尿病肾病早期诊断的临床意义

[目的]研究糖化血红蛋白A1c（HbA1c）和尿微量白蛋白（U-mAlb）联合检测对糖尿病肾病（DN）早期诊断的临床意义。[方法]分别检测109例确诊为糖尿病（DM）患者和48例体检健康者（正常对照组）的HbA1c和U-mAlb。HbA1c的检测利用高效液相色谱法,U-mAlb检测采用免疫比浊法。按照HbA1c水平高低将这109例DM患者分为低值组（HbA1c〈7.0%）,中值组（7%≤HbA1c≤10%）和高值组（HbA1c〉10%）,探讨U-mAlb在各组之间的关系。[结果]DM组与正常对照组比较,HbA1c和U-mAlb水平均明显增高,两组比较差异有显著性意义（P〈0.01）。在DM组中,低、中值组的U-mAlb水平比较,差异无显著性意义（P〉0.05）,低值组与高值组、中值组与高值组的U-mAlb水平比较,差异均有显著性意义（P〈0.01）;且随着HbA1c水平的逐渐升高,U-mAlb水平也呈增高趋势,二者呈明显的正相关关系（r=0.491,P〈0.01）。[结论]DM患者HbA1c水平和U-mAlb水平呈正相关关系,两者的水平与DM患者的早期肾脏损伤程度密切相关,二者联合检测对DN的早期诊断、早期治疗及监测有着重要意义。

Clinical significance of glycosylated hemoglobin and microalbuminuria combined detection in the early diagnosis of patients with diabetic nephropathy

[Objective] To discuss the clinical significance of glycosylated hemoglobin A1c(HbA1c) and microalbuminuria(U-mAlb)combined detection in the early diagnosis of patients with diabetic nephropathy(DN).[Methods] HbA1c and U-mAlb in 109 patients with diabetes mellitus(DM)and 48 healthy individuals,as normal control were examined.The test of HbA1c was completed by High Performance Liquid Chromatography(HPLC) and immune turbidity method was used to detect U-mAlb.According to HbA1c levels,the DM patients were divided into low(HbA1c<7.0%),medium(7%≤HbA1c≤10%)and high value(HbA1c>10%)groups.The differences of U-mAlb levels among the 3 groups were compared.[Results] The levels of HbA1c and U-mAlb were significantly higher in DM group than those of normal control group(P<0.01).In DM patients,the levels of U-mAlb had no statistical difference between the low and median value groups(P>0.05).However,U-mAlb in high value patients showed significant difference if compared to the low and medium groups(P<0.01).The level of U-mAlb presented a rising trend with the increase of HbA1c,which had a significant positive correlation(r=0.491,P<0.01).[Conclusions] In DM patients,HbA1c levels and the levels of U-mAlb have a positive correlation,their levels are closely related to the early injure of kidney with DM.Combined detection of HbA1c and U-mAlb has an important clinic significance to the early diagnosis,treatment and controlling of DN.