糖尿病性肾脏疾病

　　【摘要】 目的 探讨血清β痕迹蛋白(TP)在老年T2DM肾损伤中应用价值。 方法 将 131例T2DM老年患者分为尿白蛋白正常(NUAlb)组，微量尿白蛋白(MUAlb)组，大量尿白蛋白(CUAlb)组，另设健康对照(NC)组40名。采用胶乳增强散射免疫比浊法检测血清βTP，并与血肌酐(Scr)、胱抑素C(CysC),评估肾小球滤过率 (eGFR)等指标进行相关性分析。结果 NUAlb组血清βTP水平高于NC组(P<0.05)。NUAlb组、MUAlb组、CUAlb组血βTP、CysC、Scr阳性率分别为32.5%、30.0%、0.0%;64.6%、60.0%、12.0%和87.8%、90.2%、29.3%;三组血βTP、CysC阳性率均显著高于Scr，但βTP、CysC之间差异无统计学意义。相关分析表明，血βTP与CysC、Scr、病程、SBP及UA呈显著正相关，与eGFR 呈显著负相关;与HbA1c、FPG、DBP、BMI无相关。 结论 血清βTP对老年T2DM肾损伤评价有一定意义，其诊断敏感性明显优于Scr, 有可能成为评价肾小球滤过率新的血清学标志物。

　　【关键词】 血清β痕迹蛋白;老年;糖尿病肾病;肾小球滤过功能

　　The role of serum β trace protein in the elderly diabetic patients with renal injury ZHANG Huan-huan, ZHAO Shao-lin, ZHENG Ping, et al. The Center Laboratory of the First People’s Hospital of Lianyungang, Lianyungang 222002, China

　　Corresponding author: ZHAO Shao-lin, Email: zhaoshaolin1@163.com

　　【Abstract】 Objective To study the role of serum β trace protein (βTP) in the evaluation of renal injury in elderly T2DM. Methods The 131 old patients with T2DM were classified into three groups: normal albuminuria group (NUAlb), microalbuminuria group (MUAlb), and macroalbuminuria group (CUAlb). Forty healthy subjects were in the normal control group (NC). Serum βTP were measured by using latex particle enhanced immunoturbidimetry assay. The correlation of serum βTP with serum creatinine (Scr), cystatin C (CysC), and the estimated glomerular filtration rate (eGFR) was analyzed. Results The level of serum βTP in the NUAlb group was significantly higher than that in the NC group (P<0.05). The positive rates of serum βTP, CysC , and Scr were 32.5%, 30.0%, and 0.0% in the NUAlb group, 64.6%, 60.0%, and 12.0% in the MUAlb group, and 87.8%, 90.2%, and 30.0% in the CUAlb group respectively. The positive rates of serum βTP and CysC of the three groups were all significantly higher than that of Scr, while there was no significant difference between the positive rates of serum βTP and CysC. The correlation analysis showed that the serum βTP was positively correlated with the serum CysC, Scr, course of the disease, systolic blood pressure (SBP), and serum uric acid (UA), negatively correlated with eGFR, however, not correlated with HbA1c, fasting glucose (FPG), diastolic blood pressure (DBP), and body mass index (BMI). Conclusion Serum βTP may be useful in evaluation of early renal injury of elderly T2DM and is superior to Scr in diagnostic sensitivity. It may be a new serological index in evaluating GFR.

　　【Key words】 Serum β trace protein; Elderly; Diabetic nephropathy; Glomerular filtration function