α_1-微球蛋白检测对糖尿病肾病的意义

目的　探讨α1 微球蛋白对糖尿病肾小管损害的早期诊断价值。对比分析血、尿中α1 微球蛋白 (α1 MG)在1型和 2型糖尿病患者已发生糖尿病肾病 (DN)与未发生DN之间的关系。方法　采用ELISA技术、免疫比浊技术及化学比色法 ,将 1型和 2型糖尿病者血、尿中α1 微球蛋白以及糖水平 (糖化血浆白蛋白 )与糖尿病肾病相关性进行对比。结果　 1型和 2型糖尿病间无论是否发生DN ,血、尿中α1 MG均增高。尿α1 MG :发生DN组高于未发生DN组。 1型和 2型组未发生DN组间 ,发生DN组间比较 ,其α1 MG含量无显著性差异。血α1 MG :发生DN组与未发生DN组无显著性差异。DN发病与病程长短关系不确切 ,即病程越长发生率不一定越高 ;空腹血糖水平与DN发病有高度相关性。结论　尿α1 MG可作为肾小管功能的敏感检测物 ,早于微量白蛋白尿出现。血α1 MG含量与肾功能无关 ,不能作为肾功能检测指标。糖尿病患者控制血糖 ,可有效降低或控制DN发病。

Significance of α1-microglobulin in Patients with DN

Objective To explore the value of early dignosis of α-1-microglobulin (α-1-MG) in Diabtes mellitus (DM) patients with impairment renal tubule and compare patients having developed early diabetic nephropathy(DN) with those who haven't and analyse their correlations of α-1-MG in serum and urine .Methods α-1-MG in serum and urine were detected in 1.DM and 2.DM by using ELISA,immune turbidimetry and chemical assay.Results α-1-MG in serum and urine all increased whenever DN existed. Patients in group DN had a higher level of urineα-1-MG than those in no DN group,while no difference was found in groups of 1.DM and 2.DM. α-1-MG in serum had no significant differences in DN and no DN groups. There was a high correlation between the ratio of DN and FBG.Conclusion α-1-MG in urine serving as a sensitive index of renal tubule function appeares earlier than microabl of urine.α-1-MG in serum might bear no relation to renal function and can't serve as its index .Controls of blood glucose in DM patients can reduce and control the incidence of DN efficiently.