2型糖尿病患者肾小管间质标志蛋白检测的临床意义

目的 通过测定尿肾小管间质标志蛋白以探讨2型糖尿病患者肾小管间质病变。方法 同期测定215例2型糖尿病24h尿白蛋白(24hUAE)、视黄醇结合蛋白(RBP)、a 1-微球蛋白(a 1-MG)、B 2-微球蛋白(β2-MG)、Tamm-horsfall糖蛋白(THP)、尿糖(UG)和肌酐清除率(Ccr)。结果 1、215例2型糖尿病患者24hURBP、24hUal-MG和24hUβ2-MG增高的发生率分别为39.5％、45.1％、34.4％,且其排泄增高的发生率均随24hUAE的增加而增高;24hTHP排泄降低的发生率为40.0％;2、在微量和大量白蛋白尿患者中,24hUal-MG增高亚组与正常亚组比较,Ccr明显降低,p<0.05;3、24hURBP、24hUa 1-MG、24hUβ2-MG和24hUTHP排泄与24hUG无相关性。结论 2型糖尿病肾脏病变除肾小球病变之外,肾小管间质病变亦相当常见,甚至早于肾小球病变,并参与肾功能的损害。

Clinical signifcant of measurement of tubulointetitiun marker proteins in patients with type 2 diabetes mellitus

Objective To investigate tubulointetitiun damage in patients with type 2 diabetes mel-litus by measuring tubulointetitium marker proteins.methods 24 hour urinary albumin excretion( 24hUAE) retinol-bingding protein , a 1- microglobulin( αl-MG) , urinary glucose(UG) and creatinine clearance rate(Ccr) were measured in 215 patients whth type 2 diabetes mellitus. Results l.The raised prevalencer-ates of 24hURBP,24hUa 1-MG and 24hUb 2-MG in 215 diabetic patients were 39.5% ,45.1% ,34.4%, respectively, meanwhile, which all increased with the increase of 24hUAE,the prevalence rate of de-creased 24 UTHP was 40.0% 2.Among the patients with micro-and macro -albuminuria,Ccr in paitents with raised 24hUa 1-MG decreased singificantly in comparison with the patients with normal 24hUa 1-MG,P<0.05;3.24hURBP,24Hua 1-MG, 24hUb 2-MG and 24hUTHP had no relationship with 24hUG. Conclusion The tubulointetitium damage was rather common in type 2 diabetics except diabetic glomerulosclerosis,even earlier than glomerulus damage and may contribute to a certain extent to the reduction of renal function .