2型糖尿病肾病患者糖化血红蛋白、尿微量白蛋白及生化指标关系的研究

目的：探讨研究2型糖尿病肾病患者肾功能、糖化血红蛋白、尿微量白蛋白与血脂代谢的关系。方法120例诊断患者依尿微量白蛋白排泄率分为正常白蛋白尿（ NAU）组、微量白蛋白尿（ MAU）组和临床蛋白尿（ CAU）组，依糖化血红蛋白水平分为A、B、C三组，另外选30例体检健康者作为对照组（ NC）。检测各种生化指标：空腹血糖（ FBG）、胆固醇（ TCH）、甘油三酯（TG）、血清素氮（BUN）、血清肌酐（Cr）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）、糖化血红蛋白（HbA1C）、尿微量白蛋白（mAlb）。结果 T2DM组和NC组相比，FBG、TG、TC、LDL-C、HbA1C水平高于NC组（P＜0．01），HDL-C低于对照组（P＜0．05）；CAU组、MAU组的FBG、TG、TC、LDL-C、HbA1C指标要明显的高于NAU组（P＜0．05）；CAU的FBG、TG、TC、LDL-C、HbA1C明显大于MAU组（P＜0．01），CAU 组的HDL要低于MAU 组和NUA组（P＜0．05），2型糖尿病肾病患者在FPG、HbA1C、TCH、TG、UAE和NC组相比较差异有统计学意义（P＜0．05），BUN、Cr与NC组相对比，其差异无统计学意义（P＞0．05）。 T2DM患者各组之间FPG、HbA1C相互比较，差异有统计学意义（P＜0．05）；而各组间的TCH、TG、BUN、Cr相互比较无统计学意义（ P＞0．05）。结论2型糖尿病肾病患者的尿微量白蛋白增高程度与糖化血红蛋白的增高有关，而尿微量白蛋白是糖尿病早期肾脏损害的灵敏指标，联合检测 HbA1 C、mAlb以及各项血脂水平对糖尿病肾病的早期预防诊断及治疗有重要意义。

Correlation between glycosylated hemoglobin,urine trace albumin and other biochemical indexes of type 2 diabetic nephropathic patients

Objective To investigate the relationship among glycosylated hemoglobin （GHbA1C）,the disturbance of lipids metabolism and urinous albumin （ mAlb） excretion rate in type 2 diabetic nephropathy （ DN） .Methods A hundred and twenty patients ,in accord-ance with the urine trace albumin excretion rate ,were assigned into normal albuminuria （NAU） group,microalbuminuria（MAU） group and clinical proteinuria （ CAU） group,and in accordance with the glycated hemoglobin level were assigned into group A ,B,and C, meanwhile,30 healthy people were chosen as the control group （NC）.Various biochemical indexes including FBG ,HbA1C,TCH,TG, BUN,Cr,HDL-C,LDL-C,mAlb were detected.Results Compared with NC group,the detection rates of FBG,TG,TC,LDL-C,HbA1C was higher in T2DM group（P＆lt;0.01）,while HDL-C was lower（P＆lt;0.05）.FBG,TG,TC,LDL-C,HbA1C indexes in CAU,MAU group were significantly higher than those in NUA group （P＆lt;0.05）.FBG,TG,LDL-C,HbA1C in CAU group were significantly higher than those in MAU group（P＆lt;0.01）.HDL in CAU group was lower than that in MAU group and NUA group （P＆lt;0.05）.FPG,HbA1C, TCH,TG and UAE of patients with type 2 diabetic nephropathy were significantly different from those in NC group （P＆lt;0.05）,while BUN,Cr,compared with NC group,had no statistically significant difference （P＆gt;0.05）.FPG,HbA1C of T2DM patients were statisti-cally different among different groups（P＆lt;0.05）,while TCH,TG,BUN,Cr had no statistical significance（P＆gt;0.05）.Conclusions Increased urine trace albumin levels of type 2 diabetic nephropathic patients are associated with increased glycosylated hemoglobin .U-rine trace albumin is a sensitive index of early diabetic kidney damage .Joint detection of HbA l C,mAlb and lipid levels will have impor-tant significance in diabetic nephropathy ’ s early prevention ,diagnosis and treatment .