申志祥 陈燕 陈秀益 卞茸文

　　基金项目：江苏省卫生厅科研项目(H2005017)

　　作者单位：210024南京，江苏省老年医学研究所糖尿病防治研究中心

　　通讯作者：卞茸文，E-mail：bianrw@126.com

　　【摘要】 目的 检测不同尿白蛋白排泄率(UAER)的2型糖尿病(T2DM)患者尿N-乙酰-β-葡萄糖苷酶(NAG)、α1-微球蛋白(α1-MG)、视黄醇结合蛋白(RBP)水平，探讨其对2型糖尿病早期肾损害诊断的应用价值。 方法 选择我院就诊的T2DM患者196例，健康体检者57名，检测12小时UAER水平。根据UAER水平将T2DM患者分为UAER正常组和异常组。分别检测尿NAG、α1-MG、RBP，肌酐(Cr)水平，并分析各组间差异。 结果 196例T2DM患者NAG/Cr、α1-MG/Cr及RBP/Cr水平较健康对照组明显升高(P<0.05);与对照组比较，T2DM患者中UAER正常组及异常组NAG/Cr、α1-MG/Cr及RBP/Cr水平具有显著性差异(P<0.05或P<0.01)。在T2DM患者中，UAER与NAG/Cr、α1-MG/Cr及RBP/Cr之间没有相关性，而NAG/Cr与α1-MG/Cr及RBP/Cr之间存在相关性(P<0.01)。T2DM患者中UAER、NAG、α1-MG、RBP联合检测阳性率高于各单一指标的检测阳性率(P<0.05)。 结论 T2DM患者联合检测尿NAG、α1-MG、RBP可以提高糖尿病早期肾损害的诊断的敏感性，利于糖尿病肾病的早期预防。

　　【关键词】NAG;α1-MG;RBP;尿白蛋白排泄率;糖尿病肾病

　　doi:10.3969/j.issn.1006-6187.2011.01.005

　　The role of combination detection of urinary NAG, α1-MG, RBP in diagnosing the early renal damage in patients with type 2 diabetes

　　SHEN Zhi-xiang, CHEN Yan, CHEN Xiu-yi, et al. Department of Endocrinology, Jiangsu Province Geriatric Hospital, Nanjing 210024, China

　　Corresponding author：BIAN Rong-wen, E-mail: bianrw@126.com

　　【Abstract】Objective To investigate the value of the combination detection of urinary NAG, α1-MG, RBP in diagnosing the early renal damage in patients with type 2 diabetes.Methods196 patients with type 2 diabetes and 57 healthy cases underwent UAER assay. Patients with type 2 diabetes were divided into non-UAER group and UAER group. The levels of NAG, α1-MG, RBP, UAER and Cr were detected.  Results  The ratios of NAG/Cr and α1-MG/Cr and RBP/Cr in the patients with type 2 diabetes were higher than those in healthy cases (P<0.05). There were no significant differences in NAG/Cr and α1-MG/Cr between non-UAER group and UAER group. There were no correlations of UAER with ratios of NAG/Cr, α1-MG/Cr, RBP/Cr, while there were significant correlations among NAG/Cr, α1-MG/Cr and RBP/Cr(P<0.01). The positive rate of the combination detection of UAER, NAG, α1-MG, RBP was higher than that of the single parameter in the patients with diabetes.  Conclusions  The combination detection of urinary NAG, α1-MG, RBP could improve the diagnosis of early renal damage in the patients with diabetes.

　　【Key words】NAG; α1-MG;RBP;12-hour UAER; Diabetic nephropath