尿mALB、α_1-MG、TRF、NAG检测对糖尿病肾病早期诊断的价值

目的探讨尿微量白蛋白(mALB)、α-微球蛋白(α1-MG)、转铁蛋白(TRF)、N-乙酰-β-D氨基葡萄糖苷酶(NAG)对糖尿病肾病的早期诊断价值。方法采用免疫透射比浊法和比色法分别检测85例非胰岛素依赖型糖尿(NIDDM)病患者及62例健康体检者晨尿mALB、α1-MG、TRF、NAG含量。结果NIDDM患者mALB、α1-MG、TRF、NAG尿水平均显著高于对照组(P<0.01),血糖控制良好组尿mALB、α1-MG、TRF、NAG水平显著低于血糖控制不良组(P<0.01)。NIDDM患者中,尿mALB增高的阳性率37.65%,尿TRF增高的阳性率为56.47%,两者差异显著(P<0.05);尿NAG增高的阳性率为45.88%,与mALB比较,无显著差异(P>0.05)。尿α1-MG增高的阳性率为48.23%,与mALB差异也无显著性(P>0.05)。12例尿TRF增高(22.64%),8例尿NAG增高(15.09%),9例尿mALB(16.98%)增高,差异无显著性(P>0.05)。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检测,单项及2项检测的阳性率较低,3项联合检测阳性率较高,其中α1-MG+TRF+NAG模式达81.12%,4项联合检阳性率达87.06%。结论检测尿mALB、α1-MG、TRF、NAG是NIDDM患者早期肾损害的敏感指标,联合检测3~4项指标有较高的阳性率,对于DN的早期诊断有一定的临床意义。

The Nonage Diagnosis Value for Diabetic Nephropathy Diseases by Detection of mALB、α1-MG、TRF、NAG

Objective To investigate the nonage diagnosis value of mALB、α_1-MG、TRF、NAG for the diabetic nephroparth.Methods the immune transmission nephelometry and the colorimetry were respectively used to test the morning urine mALB、α_1-MG、TRF、NAG of 85 cases NIDDM and 62 cases physical examination.Results the mALB、α_1-MG、TRF、NAG of NIDDM patients are distinctly higher than that of the comparison group(P<0.01);these who control the blood-sugar better are lower than those who control it bad(P<0.01).Among NIDDM patients,The mALB increase positive expression 37.65%;TRF 54.47%,their difference are apparently(P<0.05),The NAG increase positive expression is 45.88%,compared with the mALB,no significant difference was found(P>0.05);the α_1-MG increase positive expression 48.23%,compared with mALB,the detection rate is slightly different(P>0.05).At the same time,12 case TRF up(22.64%);8 case NAG up(15.09%);9 case mALB up(16.98%) these three term have no distinctness(P>0.05).The sensitivity of the every sing index and associated inspection is higher remarkably than regular uric albumen check-up,the single and two index detection rate is lower,the three index co-examination higher,thereinto the α_1-MG+TRF+NAG pattern arrived at 81.12%,the association inspection mode 87.06%.Conclusion The detection of mALB、α_1-MG、TRF、NAG showed that they are the sensitive index of forepart kidney damage NIDDM patients.