血、尿β痕迹蛋白检测对2型糖尿病肾损伤早期诊断价值研究

目的探讨血、尿β痕迹蛋白(βTP)检测在2型糖尿病肾损伤中的诊断价值。方法明确诊断为2型糖尿病患者178例,按照尿Alb/Cr比值将其分为三组:Alb/Cr正常组60例,微量白蛋白尿组65例,大量白蛋白尿组53例,另设健康对照组80名。采用胶乳增强散射免疫比浊法原理检测血、尿βTP,比较各组患者血、尿βTP水平,并与Scr、eGFR以及实验及临床相关指标进行相关性分析。结果尿Alb/Cr正常的2型糖尿病患者血清βTP为(0.70±0.36)mg/dl,较健康对照组(0.59±0.12)mg/dl]显著升高(P<0.01)。微量白蛋白尿组血清βTP(0.82±0.30)mg/dl,较Alb/Cr正常组显著升高(P<0.05);大量白蛋白尿组血清βTP(1.79±1.19)mg/dl,与其他两组比较显著升高(P<0.01);三组2型糖尿病患者血清βTP阳性率分别为28.3%、60.0%和87.8%;尿液βTP/Cr阳性率分别为20%、84.6%和90.6%。相关分析结果表明,血清βTP与SC呈显著正相关,r为0.705 0(P<0.01),eGFR值与血β-TP呈显著负相关(r=-0.805 1,P<0.01)。尿βTP与Scr、HbA1c、收缩压、病程呈正相关(r分别为0.387 9、0.240 2、0.164 3、0.241 5,均P<0.05)。结论血清βTP对2型糖尿病患者早期肾损伤具有重要的诊断价值,可以早期反映肾小球滤过功能,而尿βTP/Cr可以作为评价2型糖尿病患者肾小管损伤的有效指标。

The diagnostic value of the serum and urinary beta-trace protein in the type 2 diabetic renal injury

Objective To study the diagnostic value of the serum and urine beta trace protein （βTP） in type 2 diabetes with renal injury. Methods 178 type 2 diabetes patients with confirmed diagnosis were classified into three groups according to the ratio of urine albumin to creatinine （Alb/Cr） as follows： 60 in normal Alb/Cr group, 65 in microalbuminuria group, 40 in macroalbuminuria group. 60 healthy subjects serve as normal control group. The concentrations of serum and urineβTP were measured using latex particle enhanced immunoturbidimetry assay and compared among all groups and made the correlation analysis with serum creatinine （Scr）, estimated glomerular filtration rate （eGFR）, the other laboratory and clinical related indexes. Results The serumβTP in normal Alb/Cr group was higher than that in healthy control group （0.70±0.36）mg/dl vs. （0.59±0.12）mg/dl, P〈0.01, however, was lower than that in microalbuminuria group （0.82±0.30）mg/dl vs. （0.59±0.12）mg/dl, P〈0.05. The serum βTP of macroalbuminuria group significantly increased compared to normal Alb/Cr and microalbuminuria group （both P〈0.01）. The positive rates of serum and urineβTP in three groups of type 2 diabetes patients were 28.3%, 60.0%, 87.8% and 20%, 84.6%, 90.6% respectively. The correlation analysis showed serumβTP were positively correlated with Scr（r=0.7050, P〈0.01） and were negatively correlated with eGFR （r=-0.8051, P〈0.01）. The ratio of urineβTP to creatinine （βTP/Cr） were positively correlated with Scr （r=0.3879, P〈0.05）, HbA1c（r=0.2402, P〈0.05）, systolic pressure（r=0.1643, P〈0.05） and course of the disease（r=0.2415, P〈0.05）. Conclusion The serum BTP has an important diagnostic value at the early renal injury of type 2 diabetic patients and can reflect accurately the glomerular filtration function. The urineβTP/Cr can be applied to evaluated availably renal tubular damage of type 2 diabetes patients.