不同时段尿微量清蛋白对糖尿病早期肾损害的诊断价值

目的探讨2型糖尿病肾病患者不同时段尿微量清蛋白(u-MA)变化及其对2型糖尿病患者早期肾损伤的诊断价值。方法收集糖尿病肾病患者组(n=27)和健康对照组(n=30)连续3 d的晨尿、餐后尿、随机尿和24 h尿,进行尿微量清蛋白测定。结果糖尿病患者尿微量清蛋白排泌高峰为餐后尿(61.7±26.5 mg/L),其次为晨尿(58.9±23.5 mg/L)和24 h尿(56.6±13.2 mg/L),3者显著高于随机尿(37.2±21.4 mg/L)(P<0.05),且各时段尿微量清蛋白都有较大的日间差异,以随机尿差异最大CV=57.5%,餐后尿、晨尿、和24 h尿分别为42.9%、39.9%和23.3%,糖尿病肾病患者各时段尿微量清蛋白与对照组比较差异有统计学意义(P<0.05)。结论餐后尿和晨尿微量清蛋白含量的多次检测有利于提高2型糖尿病患者早期肾损害的诊断。

Diagnostic value of the urinary albumin on the early renal impairment at various periods

Objective To explore the microalbuminuria（u-MA）change of patients with type 2 diabetic nephropathy at various periods and its diagnostic value on the early renal injury of type 2 diabetes patients.Methods We collected consecutive 3-day morning urine,postprandial urine,random urine and 24-hour urine of diabetic nephropathy patients group（n=27）and the health of the control group（n=30） for u-MA detection.Results The urinary albumin excretion and secretion peak of diabetic patients was postprandial urine（61.7 ± 26.5 mg/L）,followed by morning urine（58.9± 23.5 mg/L）and 24-hour urine（56.6±13.2 mg/L）,and the three were significantly higher than that of random urine（37.2 ± 21.4 mg/L）（P0.05）,and the result of urinary albumin in different times had larger difference,especially the random urine CV=57.5%.Postprandial urine,morning urine and 24-hour urine accounted for 42.9%,39.9% and 23.3%,respectively.There were significant differences in each period of urinary albumin between diabetic nephropathy patients and the control group（P 0.05）.Conclusion Multiple detection on the content of postprandial urine and morning urine albumin can improve early renal damage diagnosis on patients with type 2 diabetes.