2型糖尿病肾病的早期诊断探讨

目的探讨血清胱抑素C（CysC）、视黄醇结合蛋白（RBP）和尿N-乙酰-β-D氨基葡萄糖苷酶（NAG）在2型糖尿病肾病（DN）早期诊断中的临床价值。方法对115例2型糖尿病患者血清CysC、RBP、24小时尿mALB及NAG进行检验分析。根据24小时尿mALB定量将患者分为A组（无DN组）、B组（DNIII期组）、C组（DNIV期组）、D组（DNV期组）,比较4组CysC、RBP、24小时尿mALB及NAG的数值及阳性检出率。结果随着DN病情进展,血CysC、RBP、尿mALB、NAG水平呈现逐渐升高趋势。B组尿mALB、NAG水平较A组已明显升高,差异有统计学意义（P〈0.05）,而血CysC、RBP水平较A组略升高,差异无统计学意义（P〉0.25）,C组血CysC、RBP水平较A组明显升高,差异有统计学意义（P〈0.05）。B、C、D组各指标阳性率依次为尿mALB〉尿NAG〉血CysC〉血RBP。结论血清CysC、RBP和尿NAG可作为早期诊断2型DN的参考指标,联合检测有助于提高DN的早期检出率,具有临床实用价值。

Early Diagnosis of Type 2 Diabetic Nephropathy

Objective To clarify the value of serum CysC,RBP and urine NAG for the early diagnosis of type 2 DN.Methods The level of serum CysC,RBP and urine mALB,NAG were measured and analysed in 106 type 2 diabetic patients.The patients were devided into group A（without DN）,group B（DNIII）,group C（DNIV） and group D（DNV） according the level of UmALB/24h.Compared the level of serum CysC,RBP,urine NAG and the positive rate.Results The level of urine NAG in group B were higher than that in group A（P0.05）.The level of serum CysC,RBP in group B were not higher than that in group A（P0.25）,but The level of them in group C were higher than in group A（P0.05）.the order of positive rate were UmALBUNAGsCysCsRBP.Conclusion The level of sCysC、Srbp and UNAG may be indicaors for diagnosis of early type 2 DN.Combined detection can improve the positive rate,and is valuable of clinical diagnosis.