尿微量白蛋白联合尿酶检测在糖尿病肾病早期诊断中的意义

目的：探讨24h尿白蛋白排泄率（UAER）及晨尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）活性在糖尿病肾病早期诊断中的意义。方法：对尿常规中尿蛋白定性阴性或微量的2型糖尿病患者106例．测定24h尿白蛋白排泄率（UAER）及晨尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）活性。结果：28例正常对照组UAER为（15．84±6．11）mg／24h；NAG为（2．13±0．91）IU／mmol．Cr。糖尿病组106例包括尿常规蛋白定性阴性64例和微量42例。64例尿蛋白定性阴性者，UAER平均为（22．44±10．30）mg／24h，有16例高于正常对照上限，占25．0％，其余48例正常；NAG平均为（2．74±1．14）IU／mmol．Cr，有12例高于本组对照上限，占18．75％，其余52例正常；UAER和NAG合计有18例高于正常，总阳性率为28．12％。42例尿常规蛋白定性微量者：UAER平均为（40．86±18．76）mg／24h．有22例高于正常对照上限，占52．38％，其余20例正常；NAG平均为（5．01±2．34）IU／mmol．Cr，有23例高于正常对照上限，占54．76％，其余19例正常；UAER和NAG合计共有26例高于正常，占61．90％。结论：尿NAG与尿白蛋白24h排泄量的联合检测，可提高肾脏早期受损的检出率。2型糖尿病患者应每年常规进行UAER测定。

Diagnostic value of urinary mAlb and N-acetyl-β-D-glucosaminidase in patients with early diabetic nephropathy

Objective： To observe the value of UAER and NAG for early diagnosis of diabetic nephropathy. Methods： The UAER and NAG were examined in 106 cases with type 2 diabetes and urinary albumin negative or trace. Results： The UAER and the NAG were （15.84±6.11） mg/24 h and （2.13±0.91） IU/mmol.Cr in 28 normal control cases. The diabetes group included 64 cases with urinary albumin negative and 42 cases urinary albumin trace. In the urinary albumin negative group, the average of UAER was （22.44±10.30）mg/24 h, 16 cases were higher than the normal control, the rate was 25.0% （16/64）, and 48 were normal in the UAER. The average of NAG was （2.74±1.14） IU/mmol.Cr. 12 cases were higher than the normal control, the rate was 18.75%,and 52 were normal in the NAG. 18 cases were higher than normal in UAER and NAG, the positive rate was 28.12%. In the urinary albumin trace group, the average of UAER was （40.86±18.76） mg/24 h, 22 cases were higher than the normal control,the rate was 52.38%, and 20 cases were normal in the UAER. The average of NAG was （5.01±2.34） IU/mmol.Cr, 23 cases were higher than the normal control, the rate was 54.76%, and 19 cases were normal in the NAG; There were 26 cases were higher than normal in UAER and NAG, the positive rate was 61.90%. Conclusion： Combination of the UAER and NAG can advance the rate in the early stage of kidney damage. The patients with type 2 diabetes should examine the UAER every year.