尿微量白蛋白和糖化血红蛋白联合检测对糖尿病肾病早期诊断的临床价值

目的:探讨尿微量白蛋白(U-mAlb)和糖化血红蛋白(HbAlc)联合检测对糖尿病肾功能损伤早期诊断早期治疗的的临床价值。方法:随机选取健康人群标本50例,为正常对照组(A组),另外选取已确诊2型糖尿病患者标本192例,分别检测尿微量白蛋白,糖化血红蛋白,血清肌酐,根据血清肌酐浓度,按照相应公式计算血清内生肌酐清除率(Ccr),并根据内生肌酐清除率的不同分为四组,Ccr≥70 ml/min(B组62例),Ccr 70～51 ml/min组(C组35例),Ccr 50～31 ml/min(D组28例),Ccr≤30 ml/min(E组17例)。结果:尿微量白蛋白和糖化血红蛋白水平B组与A组无显著差异,C组D组E组之间也无显著差异,但C组D组E组与A组有显著差异,并成正相关。结论:尿微量白蛋白和糖化血红蛋白增高与2型糖尿病合并肾功能损伤密切相关,早期即可出现增高,联合检测可提高糖尿病肾病早期检测阳性率,对糖尿病肾病的早期诊断,早期治疗有重要意义。

Combined Determination of Urinary Albumin and Hemoglobin of Clinical Value in the Early Diagnosis of Diadetic Nephropathy

Objective： To evaluate the value of urinary albumin. （U-mAlb） and glycosylated hemoglobin （HbAlc） in diagnosis and treatment of early renal dysfunction in patients with diabetic nephropathy. Methods Fifty samples from healthy volunteers （group A, normal control） and 167 samples from patients with Type 2 Diabetes Mellitus （person-time） were randomly selected, the levels of U-mAlb, HbAlc, serum creatinine were detected and the endogenous creatinine clearance rate （Ccr） were calculated. According to different levels of Ccr, the samples from patients were divided into four groups as follow, Ccr≥70ml/min （group B, 52 person-time）, Ccr 70 -51ml/min（group C, 45 person-time）,Ccr 50 - 31ml/min（group D, 38 person-time）,Ccr ≤30ml/min（group E, 32 person-time ）. Results The levels of U-mAlb and HbAlc showed no significant difference between group A and B, significant difference of those values were found between group A and group C-E and a positive correlation was found between them, although the difference among group C, D, and E showed no statistical significance. Conclusion The increase of U-mAlb and HbAlc in early phase was associated with renal injury in patients with Type 2 Diabetes Mellitus, combination of U-mAlb and HbAlc were helpful for early diagnosis and treatment of diabetic nephropathy.