检测尿微量蛋白和Ⅳ型胶原对糖尿病肾病早期诊断的意义

目的 :探讨尿标本中视黄醇结合蛋白(RBP)、转铁蛋白(TRF)、微量白蛋白(mALB)及Ⅳ型胶原(Ⅳ C)检测在糖尿病肾病早期诊断中的作用。方法 :用ELISA法检测尿中RBP、TRF及Ⅳ C ,免疫比浊法检测尿微量白蛋白(mALB) ,酶偶联法测定尿肌酐。结果 :正常对照组中尿RBP/Cr、TRF/Cr及Ⅳ C的含量分别为(2.12±0.95)mg/mmol,(1.81±0.52)mg/mmol,(44.68±17.2)ng/ml。在糖尿病无肾病组中 ,其微量白蛋白的含量与正常对照组相近(P>0.05) ,而RBP、TRF及Ⅳ C的含量与正常对照组相比具有显著差别(P<0.05)。在糖尿病的初期肾病组和临床肾病组 ,mALB、RBP/Cr、TRF/C的及Ⅳ C的含量均明显高于正常对照组(P<0.01)。结论 :联合检测尿RBP、TRF及Ⅳ C是诊断糖尿病肾病早期损伤灵敏、可靠的实验室指标。

Clinical significance of detecting urinary microalbumin and type IV collagen in diagnosis of early diabetic nephropathy

Objective: To investigate the role of detection of urinary RBP, TRF and IV C in diagnosis of early diabetic nephropathy. Methods: Urinary RBP, TRF and IV C were determined with ELISA, urinary microalbumin with immunoturbidimetry and urinary creatinine with enzyme coupled reaction. Results: In the group of microalbuminuria of diabetes, the microalbumin content was close to that of the controls (P>0.05) while the levels of RBP, TRF and IV C were higher in the patients than in the controls (P<0.05). The levels of RBP, TRF and IV C were markedly higher in patients with early-stage and clinical stage diabetic nephropathy than in the controls (P<0.01). Conclusion: This method is sensitive and reliable for diagnosis of early diabetic nephropathy.