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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、α1MG/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。
Objective To detect the urinary N-acetyl-β-glucosidase (NAG), α1-microglobulin (α1-MG) and retinol binding protein RBP) levels, to explore its application in the diagnosis of type 2 diabetes early renal damage. Methods 196 cases of T2DM patients in our hospital, 57 healthy people, UAER levels of 12 hours were detected. T2DM patients were divided into UAER normal group and abnormal group according to UAER level. The urinary NAG, α1-MG, RBP and creatinine (Cr) levels were measured and the differences between groups were analyzed. Results Compared with the control group, the levels of NAG / Cr, α1-MG / Cr and RBP / Cr in 196 T2DM patients were significantly higher than those in healthy controls (P <0.05) α1-MG / Cr and RBP / Cr levels were significantly different (P <0.05 or P <0.01). In T2DM patients, there was no correlation between UAER and NAG / Cr, α1MG / Cr and RBP / Cr, but there was a correlation between NAG / Cr and α1-MG / Cr and RBP / Cr (P <0.01). The positive rates of UAER, NAG, α1-MG and RBP in T2DM patients were higher than those of single indicators (P <0.05). Conclusions The combined detection of urinary NAG, α1-MG and RBP in T2DM patients can improve the sensitivity of early diagnosis of diabetic nephropathy and benefit the early prevention of diabetic nephropathy.